Provider Demographics
NPI:1356696702
Name:AKIYAMA-BEVETT, YASUKO (LAC)
Entity type:Individual
Prefix:
First Name:YASUKO
Middle Name:
Last Name:AKIYAMA-BEVETT
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 1:91-2062 KAIOLI ST APT 4002
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6090
Mailing Address - Country:US
Mailing Address - Phone:808-457-2669
Mailing Address - Fax:808-689-8244
Practice Address - Street 1:1314 S KING ST
Practice Address - Street 2:#861
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1956
Practice Address - Country:US
Practice Address - Phone:808-457-2669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1014171100000X
HI277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health