Provider Demographics
NPI:1225317449
Name:SOYKIN, ALEKSANDRA STEPANENKO (PHD)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:STEPANENKO
Last Name:SOYKIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALEKSANDRA
Other - Middle Name:
Other - Last Name:STEPANENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:801 TRAEGER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3045
Mailing Address - Country:US
Mailing Address - Phone:650-742-7242
Mailing Address - Fax:
Practice Address - Street 1:801 TRAEGER AVE FL 2
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3045
Practice Address - Country:US
Practice Address - Phone:650-742-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27597103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist