Basic Information
Provider Information
NPI: 1265508055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOSHIDA
FirstName: KAY
MiddleName: CARLSON
NamePrefix: MS.
NameSuffix:  
Credential: MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4473 S URBAN CT
Address2:  
City: MORRISON
State: CO
PostalCode: 804651433
CountryCode: US
TelephoneNumber: 3039339135
FaxNumber:  
Practice Location
Address1: 2465 S DOWNING ST
Address2: SUITE 110
City: DENVER
State: CO
PostalCode: 802105822
CountryCode: US
TelephoneNumber: 3037785774
FaxNumber: 3037782436
Other Information
ProviderEnumerationDate: 11/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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