Provider Demographics
NPI:1992853592
Name:YOSHIMURA, GEORGE JOJI (PHD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:JOJI
Last Name:YOSHIMURA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KAISER MEDICAL CENTER
Mailing Address - Street 2:19000 HOMESTEAD ROAD
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-366-4262
Mailing Address - Fax:408-366-4405
Practice Address - Street 1:KAISER MEDICAL CENTER
Practice Address - Street 2:19000 HOMESTEAD ROAD
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-366-4262
Practice Address - Fax:408-366-4405
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical