Healthcare Provider Details

I. General information

NPI: 1558244871
Provider Name (Legal Business Name): MAKAYLA FIKRAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4165 BLACKHAWK PLAZA CIR STE 100
DANVILLE CA
94506-4691
US

IV. Provider business mailing address

4165 BLACKHAWK PLAZA CIR STE 100
DANVILLE CA
94506-4691
US

V. Phone/Fax

Practice location:
  • Phone: 925-736-7070
  • Fax:
Mailing address:
  • Phone: 925-736-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: