Provider Demographics
NPI:1639512759
Name:KOBASHIGAWA, WESLEY NOBUO (LMFT)
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:NOBUO
Last Name:KOBASHIGAWA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 390224
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94039-0224
Mailing Address - Country:US
Mailing Address - Phone:310-488-7979
Mailing Address - Fax:
Practice Address - Street 1:400 EDMONDS RD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3803
Practice Address - Country:US
Practice Address - Phone:650-839-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96152106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist