Healthcare Provider Details

I. General information

NPI: 1568319986
Provider Name (Legal Business Name): CHRISTINA AKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA FOWLER

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 MARLENE DR
LAFAYETTE CA
94549-4723
US

IV. Provider business mailing address

3261 MARLENE DR
LAFAYETTE CA
94549-4723
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-2138
  • Fax:
Mailing address:
  • Phone: 562-826-2138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number240057846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: