Individual
BRENT YONEO HATAKEYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
184 CALLAN AVE APT 210, SAN LEANDRO, CA 94577-4503
(408) 427-2160
Mailing address
184 CALLAN AVE APT 210, SAN LEANDRO, CA 94577-4503
(408) 427-2160
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000011564
CA
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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