Provider Demographics
NPI:1972227676
Name:MEOLA, NICOLAS ANDREAS
Entity Type:Individual
Prefix:
First Name:NICOLAS
Middle Name:ANDREAS
Last Name:MEOLA
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 1:777 N 1ST ST STE 444
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6339
Mailing Address - Country:US
Mailing Address - Phone:408-240-0070
Mailing Address - Fax:
Practice Address - Street 1:2471 MIDDLEFIELD RD STE 102
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-4029
Practice Address - Country:US
Practice Address - Phone:650-798-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor