Provider Demographics
NPI:1174896732
Name:KITAOKA, NORI
Entity type:Individual
Prefix:
First Name:NORI
Middle Name:
Last Name:KITAOKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5903
Mailing Address - Country:US
Mailing Address - Phone:415-864-1515
Mailing Address - Fax:415-864-2086
Practice Address - Street 1:101 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5903
Practice Address - Country:US
Practice Address - Phone:415-864-1515
Practice Address - Fax:415-864-2086
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50000-59999Medicaid