Doctor Name: | EDWIN KAZUO KIKUCHI |
NPI Number: | 1023049673 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | LCS4695 |
Business Practice Address: | 29099hospital Road Suite 209 Lake Arrowhead, CA - 92352 |
Business Phone Number: | 9093378219 |
Business Fax Number: | 9093378920 |
Mailing Address: | Po Box 33, RUNNING SPRINGS |
State: | CA |
Postal Code: | 923820033 |
Phone Number: | 9098672122 |
Fax Number: | |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS4695 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |