Provider Demographics
NPI:1073408068
Name:TANAKA, LUKE RICHARD (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:RICHARD
Last Name:TANAKA
Suffix:
Gender:M
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 DOWLING PL UNIT A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2012
Mailing Address - Country:US
Mailing Address - Phone:510-847-6910
Mailing Address - Fax:
Practice Address - Street 1:10 NOTTINGHAM PL
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4523
Practice Address - Country:US
Practice Address - Phone:628-251-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16047101YP2500X
CA145647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional