Healthcare Provider Details

I. General information

NPI: 1295366854
Provider Name (Legal Business Name): MYEEKA JOEL CALHOUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22245 MAIN ST STE 200
HAYWARD CA
94541-4028
US

IV. Provider business mailing address

22245 MAIN ST STE 200
HAYWARD CA
94541-4028
US

V. Phone/Fax

Practice location:
  • Phone: 510-760-3933
  • Fax: 510-727-9405
Mailing address:
  • Phone: 510-760-3933
  • Fax: 510-727-9405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: