Provider Demographics
NPI:1801814462
Name:KOBAYASHI, KAZUO (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAZUO
Middle Name:
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:KOBAYASHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:23505 CRENSHAW BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5223
Mailing Address - Country:US
Mailing Address - Phone:310-257-9486
Mailing Address - Fax:
Practice Address - Street 1:23505 CRENSHAW BLVD STE 220
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5223
Practice Address - Country:US
Practice Address - Phone:310-257-9486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8834103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist