Provider Demographics
NPI:1992354633
Name:AHKOI, SANDRA LEILANI
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEILANI
Last Name:AHKOI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 RANCHEROS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3042
Mailing Address - Country:US
Mailing Address - Phone:760-761-0515
Mailing Address - Fax:760-761-0515
Practice Address - Street 1:751 RANCHEROS DR STE 5
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3042
Practice Address - Country:US
Practice Address - Phone:760-761-0515
Practice Address - Fax:760-761-0515
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)