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Kevin Shibayama
Rehabilitation Practitioner in Culver City, California
NPI 1346771292

Kevin Shibayama is a Rehabilitation Practitioner based in Culver City, CA. Kevin Shibayama practices in Culver City, CA. The NPI Number for Kevin Shibayama is 1346771292 and holds a License No. 122898 III (California).

The current practice location address for Kevin Shibayama is 9808 Venice Blvd Ste 700, Culver City, CA and can be reached out via phone at 310-945-3350 and via fax at 310-945-3356.

Location: 9808 Venice Blvd Ste 700, Culver City, CA, 90232-6824
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346771292
Provider Name
Kevin Shibayama
Credential
Provider Entity Type
Individual
Gender
Male
Address
9808 Venice Blvd Ste 700, Culver City, CA, 90232-6824
Phone Number
310-945-3350
Fax Number
310-945-3356
Provider Enumeration Date
03/22/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
122898 III 01 CA CATC III
institution
Provider Business Practice Location Address Details
Address
9808 Venice Blvd Ste 700
City
Culver City
State
California
Zip
90232-6824
Phone Number
310-945-3350
Fax Number
310-945-3356
person
Provider Business Mailing Address Details
Address
9808 Venice Blvd Ste 700
City
Culver City
State
California
Zip
90232-6824
Phone Number
310-945-3350
Fax Number
310-945-3356
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
122898 III (California)
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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