Provider Demographics
NPI:1831995406
Name:OKITUKUNDA, AMIRAH M
Entity type:Individual
Prefix:
First Name:AMIRAH
Middle Name:M
Last Name:OKITUKUNDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 BECK CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-8760
Mailing Address - Country:US
Mailing Address - Phone:209-895-1906
Mailing Address - Fax:
Practice Address - Street 1:801 MISSION ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3616
Practice Address - Country:US
Practice Address - Phone:209-895-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty