Provider Demographics
NPI:1750178810
Name:KUBO, NATSUNE (MSW, PPS-C, ASW)
Entity type:Individual
Prefix:
First Name:NATSUNE
Middle Name:
Last Name:KUBO
Suffix:
Gender:
Credentials:MSW, PPS-C, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 JANES RD
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4797
Mailing Address - Country:US
Mailing Address - Phone:707-822-4619
Mailing Address - Fax:
Practice Address - Street 1:3001 JANES RD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4797
Practice Address - Country:US
Practice Address - Phone:707-822-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool