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NPI Code Detail

MEDICARE: NIINANA KWEKU

MEDICARE: NIINANA KWEKU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1164720538
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIINANA KWEKU
Provider Business Mailing Address
First Line : 2420 MARTIN RD STE 200
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-8610
Country : US
Telephone Number : 707-399-4520
Fax Number :
Provider Business Practice Location Address
First Line : 2420 MARTIN RD STE 200
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-8610
Country : US
Telephone Number : 707-399-4520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2011
Last Update Date : 09/15/2021

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Directions to “ NIINANA KWEKU ” Practice Location

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