Provider Demographics
NPI:1134738875
Name:KAS-OSOKA, UGOCHUKWU
Entity type:Individual
Prefix:
First Name:UGOCHUKWU
Middle Name:
Last Name:KAS-OSOKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 PARK SHARON DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-2535
Mailing Address - Country:US
Mailing Address - Phone:408-375-3061
Mailing Address - Fax:
Practice Address - Street 1:164 PARK SHARON DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-2535
Practice Address - Country:US
Practice Address - Phone:408-375-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty