Provider Demographics
NPI:1376754960
Name:MAKUNJE, ANDREA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:MAKUNJE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:CHIRWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 ROLAND WAY STE 150
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-2027
Mailing Address - Country:US
Mailing Address - Phone:510-839-3800
Mailing Address - Fax:510-839-3888
Practice Address - Street 1:401 ROLAND WAY STE 150
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2027
Practice Address - Country:US
Practice Address - Phone:510-839-3800
Practice Address - Fax:510-839-3888
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist