# CHASE KIYOSHI YAMAMOTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275141236
- **Gender:** Man
- **Credential:** CBRS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 172V00000X | Community Health Worker | — | NULL | — |

## Other

- **Enumeration date:** 07/16/2020
- **Last updated:** 10/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AD005757R | DRIVERS LICENSE | ID |