Provider Demographics
NPI:1275882557
Name:COLEMAN, CHRISTIANAH JOLAADE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANAH
Middle Name:JOLAADE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHRISTIANAH
Other - Middle Name:JOLAADE
Other - Last Name:ODENIYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:17400 BURBANK BLVD APT 234
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1712
Mailing Address - Country:US
Mailing Address - Phone:951-907-1344
Mailing Address - Fax:
Practice Address - Street 1:17400 BURBANK BLVD APT 234
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1712
Practice Address - Country:US
Practice Address - Phone:951-907-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)