Provider Demographics
NPI:1609203306
Name:CONTEH, MICHAELLA M
Entity Type:Individual
Prefix:MRS
First Name:MICHAELLA
Middle Name:M
Last Name:CONTEH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MICHAELLA
Other - Middle Name:M
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2810 LONE TREE WAY STE 9
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4956
Mailing Address - Country:US
Mailing Address - Phone:925-642-1218
Mailing Address - Fax:
Practice Address - Street 1:2810 LONE TREE WAY STE 9
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4956
Practice Address - Country:US
Practice Address - Phone:925-642-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1002081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical