Kose Ikenasio, LCSW Valid NPI
Individual provider · Clinical Social Worker · Moreno Valley, CA
- NPI
- 1417352501
- Type
- Individual (Type 1)
- Primary specialty
- Clinical Social Worker (Social Worker)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 1041C0700X
- License number
- 99620 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2014-10-31
- Last updated
- 2026-06-01
Practice location
23990 Eucalyptus Ave
Moreno Valley, CA 92553-5504
(951) 956-3123