Provider Demographics
NPI:1952002453
Name:TSUKAMOTO, ADAM Y
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:Y
Last Name:TSUKAMOTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 TOPEKA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1938
Mailing Address - Country:US
Mailing Address - Phone:408-834-5846
Mailing Address - Fax:
Practice Address - Street 1:7500 ARROYO CIR STE 180
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7339
Practice Address - Country:US
Practice Address - Phone:408-418-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician