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1700035672
MICHAEL ICHINAGA
SAN JOSE, CA
NPI
1700035672
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY12062)
Enumeration Date
2008-09-15
Last Update Date
2008-09-15
Business Address
-- MICHAEL ICHINAGA Ph.D.
828 S BASCOM AVE
SAN JOSE, CA 95128-2651
Phone number: 408-885-5776
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Mailing Address
-- MICHAEL ICHINAGA Ph.D.
1901 HALFORD AVE APT 185
SANTA CLARA, CA 95051-7413
Phone number: 408-261-2284
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