Individual
SIUVAO M HALATOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9750 BANCROFT AVE APT 111, OAKLAND, CA 94603-1916
(510) 640-3682
Mailing address
9750 BANCROFT AVE APT 111, OAKLAND, CA 94603-1916
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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