Provider Demographics
NPI:1720316490
Name:HATANAKA, YUKIKO
Entity type:Individual
Prefix:
First Name:YUKIKO
Middle Name:
Last Name:HATANAKA
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 1:9500 MALECH DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2004
Mailing Address - Country:US
Mailing Address - Phone:408-281-6542
Mailing Address - Fax:408-281-3580
Practice Address - Street 1:9500 MALECH DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-2004
Practice Address - Country:US
Practice Address - Phone:408-281-6542
Practice Address - Fax:082-816-5804
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112486106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor