Provider Demographics
NPI:1720316490
Name:HATANAKA, YUKIKO
Entity Type:Individual
Prefix:
First Name:YUKIKO
Middle Name:
Last Name:HATANAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PARKMOOR AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3798
Mailing Address - Country:US
Mailing Address - Phone:408-961-9849
Mailing Address - Fax:408-961-9856
Practice Address - Street 1:46 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3130
Practice Address - Country:US
Practice Address - Phone:408-961-9849
Practice Address - Fax:408-961-9856
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA112486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor