Provider Demographics
NPI:1164737128
Name:CALHOUN, AKILI K
Entity Type:Individual
Prefix:MR
First Name:AKILI
Middle Name:K
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4368 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2529
Mailing Address - Country:US
Mailing Address - Phone:510-531-3111
Mailing Address - Fax:510-530-8083
Practice Address - Street 1:1153 OAK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2216
Practice Address - Country:US
Practice Address - Phone:415-431-9000
Practice Address - Fax:415-431-1813
Is Sole Proprietor?:No
Enumeration Date:2010-08-15
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA63022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist