Healthcare Provider Details

I. General information

NPI: 1255188488
Provider Name (Legal Business Name): ENIKARINA AKAMANDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 N THOMPSON ST
HEMET CA
92543-4311
US

IV. Provider business mailing address

3084 BRADLEY RD
PERRIS CA
92571-3774
US

V. Phone/Fax

Practice location:
  • Phone: 951-750-9608
  • Fax:
Mailing address:
  • Phone: 951-550-6712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: