Provider Demographics
NPI:1558436956
Name:SUKIENNIK-TAKAOKA, ANA V (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:V
Last Name:SUKIENNIK-TAKAOKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:V
Other - Last Name:SUKIENNIK-TAKAOKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-1000
Mailing Address - Fax:510-752-6845
Practice Address - Street 1:275 W MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5641
Practice Address - Country:US
Practice Address - Phone:510-752-1000
Practice Address - Fax:510-752-6845
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16467103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist