Provider Demographics
NPI:1265922900
Name:FIUANGAIHETAU, MELE SEINI
Entity type:Individual
Prefix:
First Name:MELE
Middle Name:SEINI
Last Name:FIUANGAIHETAU
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 1:1172 SHADOWCLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5830
Mailing Address - Country:US
Mailing Address - Phone:510-883-4303
Mailing Address - Fax:
Practice Address - Street 1:3727 SUNSET LN STE 210
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6135
Practice Address - Country:US
Practice Address - Phone:925-753-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical