Provider Demographics
NPI:1003964289
Name:AKULLIAN, DAVID (MFCC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:AKULLIAN
Suffix:
Gender:M
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 SHATTUCK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1570
Mailing Address - Country:US
Mailing Address - Phone:510-848-4203
Mailing Address - Fax:510-848-4203
Practice Address - Street 1:1543 SHATTUCK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1570
Practice Address - Country:US
Practice Address - Phone:510-848-4203
Practice Address - Fax:510-848-4203
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT13690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health