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MIMIKO WATANABE
NPI 1528437704
Psychologist - Clinical in Philadelphia, PA

Active since September 17, 2015
1411 S 15TH ST, PHILADELPHIA, PA 19146(646) 712-3919 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jan 6, 2022, Dec 10, 2021 (2 updates tracked since 2021).

About Mimiko Watanabe NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIMIKO WATANABE (NPI 1528437704) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS019468) and active in the NPI registry since September 2015.

NPPES Registry Identity

NPI1528437704
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMIMIKO WATANABE
Location Address1411 S 15TH STPhiladelphia, PA 19146-4803
Mailing Address429 Littlecroft RdUpper Darby, PA 19082-4909 · (646) 712-3919
Phone(646) 712-3919
Sole ProprietorNo
Enumeration DateSeptember 17, 2015
Last NPPES UpdateJanuary 6, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2022
✔ NPI 1528437704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in PA · PS019468
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1411 S 15TH ST, Philadelphia, PA 19146
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mimiko Watanabe's NPI number?

The NPI number for Mimiko Watanabe is 1528437704. It was assigned to this individual provider in the NPPES registry on September 17, 2015.

Where is Mimiko Watanabe located?

Mimiko Watanabe practices at 1411 S 15th St, Philadelphia, PA 19146. The listed phone number is (646) 712-3919.

What is Mimiko Watanabe's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Mimiko Watanabe was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.