Provider Demographics
NPI:1689626939
Name:TANIGUCHI, KANAKO (LCSW)
Entity Type:Individual
Prefix:
First Name:KANAKO
Middle Name:
Last Name:TANIGUCHI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21830 S VERMONT AVE
Mailing Address - Street 2:#6
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2110
Mailing Address - Country:US
Mailing Address - Phone:310-951-6747
Mailing Address - Fax:310-320-4219
Practice Address - Street 1:21830 S VERMONT AVE
Practice Address - Street 2:#6
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2110
Practice Address - Country:US
Practice Address - Phone:310-951-6747
Practice Address - Fax:310-320-4219
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS203701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW20370Medicare PIN