Provider Demographics
NPI:1407423718
Name:AKOLO, MELEANA KEHAULANI
Entity Type:Individual
Prefix:MS
First Name:MELEANA
Middle Name:KEHAULANI
Last Name:AKOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2305
Mailing Address - Country:US
Mailing Address - Phone:650-343-8401
Mailing Address - Fax:
Practice Address - Street 1:6563 SHATTUCK AVE APT 8
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1046
Practice Address - Country:US
Practice Address - Phone:925-405-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)