Provider Demographics
NPI:1033763834
Name:JANI, SOPHIE KARUNAN (MFT)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:KARUNAN
Last Name:JANI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 14TH ST STE 912
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2725
Mailing Address - Country:US
Mailing Address - Phone:510-575-0974
Mailing Address - Fax:
Practice Address - Street 1:436 14TH ST STE 912
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2725
Practice Address - Country:US
Practice Address - Phone:510-575-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106468106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty