Healthcare Provider Details

I. General information

NPI: 1265922900
Provider Name (Legal Business Name): MELE SEINI FIUANGAIHETAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 SUNSET LN STE 210
ANTIOCH CA
94509-6135
US

IV. Provider business mailing address

1172 SHADOWCLIFF WAY
BRENTWOOD CA
94513-5830
US

V. Phone/Fax

Practice location:
  • Phone: 925-753-2156
  • Fax:
Mailing address:
  • Phone: 510-883-4303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: