Provider Demographics
NPI:1396426318
Name:OWUSU-DONKOR, AKWASI
Entity type:Individual
Prefix:
First Name:AKWASI
Middle Name:
Last Name:OWUSU-DONKOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11040 BOLLINGER CANYON RD STE 155
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-4969
Mailing Address - Country:US
Mailing Address - Phone:925-915-0610
Mailing Address - Fax:
Practice Address - Street 1:11040 BOLLINGER CANYON RD STE 155
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-4969
Practice Address - Country:US
Practice Address - Phone:925-915-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-001192103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst