Provider Demographics
NPI:1659574697
Name:BOYKIN, LATEEFAH
Entity Type:Individual
Prefix:MS
First Name:LATEEFAH
Middle Name:
Last Name:BOYKIN
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 1:1310 TURK ST
Mailing Address - Street 2:#504
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-8716
Mailing Address - Country:US
Mailing Address - Phone:415-674-8525
Mailing Address - Fax:
Practice Address - Street 1:1441 CHINOOK CT
Practice Address - Street 2:#A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94130-1629
Practice Address - Country:US
Practice Address - Phone:415-394-9082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)