Healthcare Provider Details

I. General information

NPI: 1982889317
Provider Name (Legal Business Name): GAIK KEE KHOO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 INTERNATIONAL BLVD
OAKLAND CA
94606-2235
US

IV. Provider business mailing address

1130 N ABBOTT AVE
MILPITAS CA
95035-2911
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-2777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF 54992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: