Healthcare Provider Details

I. General information

NPI: 1811023468
Provider Name (Legal Business Name): JOHN ANDONAKAKIS MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MISSION ST STE 205L
SAN FRANCISCO CA
94103-2511
US

IV. Provider business mailing address

1460 MISSION ST
SAN FRANCISCO CA
94103-2511
US

V. Phone/Fax

Practice location:
  • Phone: 415-535-9088
  • Fax: 415-355-2338
Mailing address:
  • Phone: 415-535-9088
  • Fax: 415-355-2338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number50909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: