Provider Demographics
NPI:1801778261
Name:FUKUI, KINU
Entity type:Individual
Prefix:
First Name:KINU
Middle Name:
Last Name:FUKUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 BETTY CT
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-4405
Mailing Address - Country:US
Mailing Address - Phone:707-298-4453
Mailing Address - Fax:
Practice Address - Street 1:1560 BETTY CT
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-4405
Practice Address - Country:US
Practice Address - Phone:707-298-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator