Provider Demographics
NPI:1902190945
Name:HASEGAWA, AHKI (LVN)
Entity Type:Individual
Prefix:MISS
First Name:AHKI
Middle Name:
Last Name:HASEGAWA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1132
Mailing Address - Country:US
Mailing Address - Phone:714-998-9817
Mailing Address - Fax:714-282-2801
Practice Address - Street 1:233 S QUINTANA DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4029
Practice Address - Country:US
Practice Address - Phone:714-998-9817
Practice Address - Fax:714-282-2801
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 256637101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor