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Individual

ANTONIA K FOKKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
568 W GRAND AVE, OAKLAND, CA 94612-1618
(510) 268-7332
(510) 451-4703
Mailing address
568 W GRAND AVE, OAKLAND, CA 94612-1618
(510) 268-7332
(510) 451-4703

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC 37674
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8116
CA
Enumeration date
05/17/2007
Last updated
07/08/2007
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