Provider Demographics
NPI:1215296041
Name:YOSHIMOTO, JILLIAN EMIKO (DO)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:EMIKO
Last Name:YOSHIMOTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1156 KALOLI LOOP
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5412
Mailing Address - Country:US
Mailing Address - Phone:425-802-7084
Mailing Address - Fax:
Practice Address - Street 1:7200 SKYWAY
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3280
Practice Address - Country:US
Practice Address - Phone:530-877-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A156492084P0804X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program