Healthcare Provider Details

I. General information

NPI: 1043429996
Provider Name (Legal Business Name): CHRISTINE MUKAI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BANCROFT AVE SUITE 125C
OAKLAND CA
94605
US

IV. Provider business mailing address

535 PIERCE STREET UNIT #2211
ALBANY CA
94706
US

V. Phone/Fax

Practice location:
  • Phone: 510-383-5068
  • Fax: 510-383-5100
Mailing address:
  • Phone: 510-559-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: