Individual
KAZUKO KIM MIZUSHIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 13TH ST, MODESTO, CA 95354-2437
(209) 884-2424
Mailing address
5642 ALLOWAY ST, SACRAMENTO, CA 95835-2361
(310) 666-2571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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