Healthcare Provider Details

I. General information

NPI: 1114996097
Provider Name (Legal Business Name): CHRISTINA S SITENGA-KAKO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TRANCAS ST
NAPA CA
94558-2906
US

IV. Provider business mailing address

PO BOX 9216
VALLEJO CA
94591-9216
US

V. Phone/Fax

Practice location:
  • Phone: 707-252-4411
  • Fax: 510-525-8982
Mailing address:
  • Phone: 707-252-4411
  • Fax: 510-525-8982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberG69887
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG69887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: