Provider Demographics
NPI:1942440722
Name:OKABE, EMIKO (LAC)
Entity Type:Individual
Prefix:MS
First Name:EMIKO
Middle Name:
Last Name:OKABE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 BLUE RAVINE RD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4756
Mailing Address - Country:US
Mailing Address - Phone:916-989-1014
Mailing Address - Fax:916-989-1461
Practice Address - Street 1:193 BLUE RAVINE RD
Practice Address - Street 2:SUITE 245
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4756
Practice Address - Country:US
Practice Address - Phone:916-989-1014
Practice Address - Fax:916-989-1461
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist