Provider Demographics
NPI:1962959163
Name:AKINKUOWO, RENATA
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:AKINKUOWO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOT
Other - Middle Name:
Other - Last Name:APPLICABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1962
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95741-1962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1430 BLUE OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-5155
Practice Address - Country:US
Practice Address - Phone:916-800-1062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health