Provider Demographics
NPI:1093075822
Name:BOYKIN, ATIIM BOMANI (MA, MHRS)
Entity Type:Individual
Prefix:MR
First Name:ATIIM
Middle Name:BOMANI
Last Name:BOYKIN
Suffix:
Gender:M
Credentials:MA, MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3022
Mailing Address - Country:US
Mailing Address - Phone:415-377-4045
Mailing Address - Fax:510-898-9270
Practice Address - Street 1:1500 MISSION STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:415-377-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-27
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor