Provider Demographics
NPI:1871715664
Name:MASUDA, YOKO MAYDEEN (MA, OTR, SWC)
Entity type:Individual
Prefix:
First Name:YOKO
Middle Name:MAYDEEN
Last Name:MASUDA
Suffix:
Gender:F
Credentials:MA, OTR, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 S DUNSMUIR AVE
Mailing Address - Street 2:#104
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4073
Mailing Address - Country:US
Mailing Address - Phone:323-774-9646
Mailing Address - Fax:
Practice Address - Street 1:1240 N MISSION RD
Practice Address - Street 2:3L24B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1019
Practice Address - Country:US
Practice Address - Phone:323-226-3771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT511225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics