Healthcare Provider Details

I. General information

NPI: 1083856405
Provider Name (Legal Business Name): SETIMA KIMO UILA AA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 9TH ST
SAN FRANCISCO CA
94103-4411
US

IV. Provider business mailing address

440 9TH ST
SAN FRANCISCO CA
94103-4411
US

V. Phone/Fax

Practice location:
  • Phone: 415-621-6551
  • Fax: 415-621-5466
Mailing address:
  • Phone: 415-621-6551
  • Fax: 415-621-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: