Provider Demographics
NPI:1265668305
Name:KRAKOWER, ARIEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:
Last Name:KRAKOWER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ARIELA
Other - Middle Name:
Other - Last Name:SHALEV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:113 HUMPHREY LN
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-7234
Mailing Address - Country:US
Mailing Address - Phone:510-847-8549
Mailing Address - Fax:
Practice Address - Street 1:113 HUMPHREY LN
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-7234
Practice Address - Country:US
Practice Address - Phone:510-847-8549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31672103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical