Provider Demographics
NPI:1497640601
Name:SAKAMOTO, EVAN HIROSHI
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:HIROSHI
Last Name:SAKAMOTO
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 1:2546 W 227TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3016
Mailing Address - Country:US
Mailing Address - Phone:424-558-2737
Mailing Address - Fax:
Practice Address - Street 1:2546 W 227TH ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3016
Practice Address - Country:US
Practice Address - Phone:424-558-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician