Provider Demographics
NPI:1992825194
Name:NAKAMURA, YOSHITO (MFC THERAPIST)
Entity Type:Individual
Prefix:
First Name:YOSHITO
Middle Name:
Last Name:NAKAMURA
Suffix:
Gender:M
Credentials:MFC THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1705
Mailing Address - Country:US
Mailing Address - Phone:213-483-3000
Mailing Address - Fax:213-483-6529
Practice Address - Street 1:1319 WILSHIRE BLVD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017
Practice Address - Country:US
Practice Address - Phone:213-483-3000
Practice Address - Fax:213-483-6529
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC-47373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist