Provider Demographics
NPI:1114996097
Name:SITENGA-KAKO, CHRISTINA S (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:S
Last Name:SITENGA-KAKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9216
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-9216
Mailing Address - Country:US
Mailing Address - Phone:707-252-4411
Mailing Address - Fax:510-525-8982
Practice Address - Street 1:1000 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2906
Practice Address - Country:US
Practice Address - Phone:707-252-4411
Practice Address - Fax:510-525-8982
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69887208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G698870Medicaid
00G698870Medicare PIN
CA00G698870Medicaid