Individual
ANNIKA MARIKO MIYAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-7667
Mailing address
1271 WASHINGTON AVE # 719, SAN LEANDRO, CA 94577-3646
(707) 495-6286
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY33645
CA
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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