Provider Demographics
NPI:1881946754
Name:TOMINAGA, JUNKO
Entity type:Individual
Prefix:
First Name:JUNKO
Middle Name:
Last Name:TOMINAGA
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 1:241 JEANETTE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6016
Mailing Address - Country:US
Mailing Address - Phone:714-683-6866
Mailing Address - Fax:
Practice Address - Street 1:12900 GARDEN GROVE BLVD
Practice Address - Street 2:225B
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2006
Practice Address - Country:US
Practice Address - Phone:714-636-6286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical