MEDICARE: DR. NINA PATRICIA AKIN P.H.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY19490	CA

General Provider Information

NPI Number	:	1104897222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NINA PATRICIA AKIN P.H.D

Provider Business Mailing Address
First Line	:	PO BOX 711165
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92171-1165
Country	:	US
Telephone Number	:	619-757-4408
Fax Number	:	866-210-1787

Provider Business Practice Location Address
First Line	:	4081 STEPHENS ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1242
Country	:	US
Telephone Number	:	619-757-4498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	07/08/2007

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