Edwin Kazuo Kikuchi, MSW
Individual provider Active NPI Clinical Social Worker · Lake Arrowhead, CA
NPI 1023049673 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023049673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS4695 (CA)
- Practice address
- 29099Hospital Road
Suite 209
Lake Arrowhead, CA 92352 - Phone
- (909) 337-8219
- Fax
- (909) 337-8920
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS4695 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS4695 | CA | Yes |
Addresses
Primary practice location
29099Hospital Road
Suite 209
Lake Arrowhead, CA 92352
Mailing address
PO Box 33
Running Springs, CA 92382-0033
Phone (909) 867-2122
Other providers in Lake Arrowhead, CA
- Kwangja Lee Hong
- Corey K Houmand
- Lisa Lynne Hower
- Lisa James
- Kieth J. Burkart, O.D., a Professional Corporation
- Knots and Hands
- Kim Ruth Kupfer Meares
- Kyi Kyi Thwin Win MD Inc
- Lake Arrowhead Fire District
- Lake Arrowhead Home Health Care, LLC
All providers in Lake Arrowhead, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.