Provider Demographics
NPI:1013160472
Name:TAKASHIMA, MAKI (ND)
Entity Type:Individual
Prefix:DR
First Name:MAKI
Middle Name:
Last Name:TAKASHIMA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 PACIFIC ST STE B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4438
Mailing Address - Country:US
Mailing Address - Phone:831-920-2211
Mailing Address - Fax:831-920-2311
Practice Address - Street 1:969 PACIFIC ST STE B
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4438
Practice Address - Country:US
Practice Address - Phone:831-920-2211
Practice Address - Fax:831-920-2311
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-303175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath