Provider Demographics
NPI:1780269043
Name:NINA L. YOKOCHI, DO, PLLC
Entity type:Organization
Organization Name:NINA L. YOKOCHI, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKOCHI-FUNKHOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-520-2317
Mailing Address - Street 1:4100 CHAPRA DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2051
Mailing Address - Country:US
Mailing Address - Phone:304-520-2317
Mailing Address - Fax:
Practice Address - Street 1:2311 CANTERWOOD DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7300
Practice Address - Country:US
Practice Address - Phone:910-520-9026
Practice Address - Fax:910-763-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health