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General NPI Number Information
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NPI Number | 1407081425
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Entity Type | Individual
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Provider Name | AKHILA ELIZABETH A KOLESAR PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 295 FELL ST STE A
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-5147
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Country | US
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Telephone | 415-650-6261
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Fax | 415-757-0130
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Provider Business Mailing Address
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Address Line | 912 COLE ST # 239
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-4316
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Country | US
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Telephone | 415-650-6261
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Fax | 415-757-0130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 25015
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License Number State | CA
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