Provider Demographics
NPI:1407081425
Name:KOLESAR, AKHILA ELIZABETH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:AKHILA ELIZABETH
Middle Name:A
Last Name:KOLESAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:912 COLE ST
Mailing Address - Street 2:# 239
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4316
Mailing Address - Country:US
Mailing Address - Phone:415-650-6261
Mailing Address - Fax:415-757-0130
Practice Address - Street 1:295 FELL ST
Practice Address - Street 2:STE A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5147
Practice Address - Country:US
Practice Address - Phone:415-650-6261
Practice Address - Fax:415-757-0130
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25015103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist