Provider Demographics
NPI:1770009953
Name:KUUKKA, NIINA MARITTA ELIZABETH (LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:NIINA
Middle Name:MARITTA ELIZABETH
Last Name:KUUKKA
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S WINCHESTER BLVD STE A103
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3914
Mailing Address - Country:US
Mailing Address - Phone:408-583-5099
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE A103
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3914
Practice Address - Country:US
Practice Address - Phone:408-583-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11681101YM0800X
CA130671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health