Healthcare Provider Details

I. General information

NPI: 1376157255
Provider Name (Legal Business Name): KARA L FUKUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7966 OLD WINDING WAY SUITE 300
FAIR OAKS CA
95628
US

IV. Provider business mailing address

7966 OLD WINDING WAY SUITE 300
FAIR OAKS CA
95628
US

V. Phone/Fax

Practice location:
  • Phone: 916-436-1803
  • Fax:
Mailing address:
  • Phone: 916-436-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: