Provider Demographics
NPI:1447447073
Name:AKOUKA, KARINA TATIANA
Entity type:Individual
Prefix:MS
First Name:KARINA
Middle Name:TATIANA
Last Name:AKOUKA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7250 REDWOOD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3269
Mailing Address - Country:US
Mailing Address - Phone:415-761-1197
Mailing Address - Fax:
Practice Address - Street 1:7250 REDWOOD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3269
Practice Address - Country:US
Practice Address - Phone:415-761-1197
Practice Address - Fax:707-553-5824
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA660961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical