Irina Tsukanova, CADC I
Rehabilitation Practitioner in San Jose, CA. Individual provider (NPI-1).
NPI number1356982011
StatusActive
Last updated in NPPESSep 25, 2026
Details
- NPI
- 1356982011
- Entity type
- Individual (NPI-1)
- Name
- Irina Tsukanova
- Credential
- CADC I
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2019
- Certification date
- Sep 25, 2026
- Last updated
- Sep 25, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | Ci36440922 | CA | Yes |
| 101Y00000X | Counselor | – | – | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | Ci36440922 | CA | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
210 N 4th StSan Jose, CA 95112-5569
Phone 669-245-3429
Mailing address
210 N 4th StSan Jose, CA 95112-5569
Phone 669-245-3429
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