Provider Demographics
NPI:1568046043
Name:KANSIIME, BATESI ANNAH
Entity Type:Individual
Prefix:
First Name:BATESI
Middle Name:ANNAH
Last Name:KANSIIME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 CURRAN AVE APT D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3135
Mailing Address - Country:US
Mailing Address - Phone:707-921-6199
Mailing Address - Fax:
Practice Address - Street 1:3055 CURRAN AVE APT D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3135
Practice Address - Country:US
Practice Address - Phone:707-921-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral