Provider Demographics
NPI:1467285817
Name:KAYO SUMISAKI LMFT A LICENSED MARRIAGE AND FAMILY THERAPIST INC.
Entity type:Organization
Organization Name:KAYO SUMISAKI LMFT A LICENSED MARRIAGE AND FAMILY THERAPIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMISAKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-932-2020
Mailing Address - Street 1:1200 FITZGERALD DRIVE
Mailing Address - Street 2:#1142
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2252
Mailing Address - Country:US
Mailing Address - Phone:510-932-2020
Mailing Address - Fax:
Practice Address - Street 1:5764 S BUG SPRINGS LOOP
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747
Practice Address - Country:US
Practice Address - Phone:510-932-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health