Healthcare Provider Details

I. General information

NPI: 1972437309
Provider Name (Legal Business Name): KAREN LOUISE FUKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3969 LA CRESENTA RD UNIT A
EL SOBRANTE CA
94803-2944
US

IV. Provider business mailing address

3969 LA CRESENTA RD UNIT A
EL SOBRANTE CA
94803-2944
US

V. Phone/Fax

Practice location:
  • Phone: 707-699-5659
  • Fax:
Mailing address:
  • Phone: 707-699-5659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberNBDT-00196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: