Healthcare Provider Details

I. General information

NPI: 1992625354
Provider Name (Legal Business Name): ANNA KROKHMAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 E HAMILTON AVE STE 203
CAMPBELL CA
95008-0244
US

IV. Provider business mailing address

15123 HERRING AVE
SAN JOSE CA
95124-3425
US

V. Phone/Fax

Practice location:
  • Phone: 650-855-2008
  • Fax:
Mailing address:
  • Phone: 650-930-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: