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Individual
KEVIN SHIBAYAMA
Active
Individual
KEVIN SHIBAYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
122898 III
CA
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122898 III
CATC III
CA
Enumeration date
03/22/2017
Last updated
12/21/2018
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