Provider Demographics
NPI:1669598785
Name:MINAGAWA, RAHN YUKIO (PHD)
Entity type:Individual
Prefix:DR
First Name:RAHN
Middle Name:YUKIO
Last Name:MINAGAWA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 5TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6964
Mailing Address - Country:US
Mailing Address - Phone:619-231-2668
Mailing Address - Fax:619-231-4133
Practice Address - Street 1:614 5TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6964
Practice Address - Country:US
Practice Address - Phone:619-231-2668
Practice Address - Fax:619-231-4133
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 9854103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical