Provider Demographics
NPI:1871363861
Name:KALOKO, ISATU YAKATIE
Entity type:Individual
Prefix:
First Name:ISATU
Middle Name:YAKATIE
Last Name:KALOKO
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 1:5680 KING CENTRE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5755
Mailing Address - Country:US
Mailing Address - Phone:571-388-0172
Mailing Address - Fax:
Practice Address - Street 1:5680 KING CENTRE DR STE 600
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5755
Practice Address - Country:US
Practice Address - Phone:571-388-0172
Practice Address - Fax:571-771-1076
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X, 252Y00000X, 261QD1600X, 372500000X, 376J00000X, 376K00000X, 385H00000X
VA1401188821376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171W00000XOther Service ProvidersContractor
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care