Individual provider Active NPI

Akhila Elizabeth A Kolesar, PH.D.

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1407081425
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
25015 Issued in CA
Practice address
295 Fell St
Ste a
San Francisco, CA 94102-5147
Phone
(415) 650-6261
Fax
(415) 757-0130
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 25015 CA Primary

Addresses

Primary practice location

295 Fell St
Ste a
San Francisco, CA 94102-5147

Mailing address

912 Cole St
# 239
San Francisco, CA 94117-4316
Phone (415) 650-6261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160503002281 CA Practitioner - Clinical Psychologist 6608175294 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

295 Fell St
Suite a
San Francisco, CA 94102-5147
Phone (415) 650-6261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1407081425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 COLE ST",
            "address_2": "# 239",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941174316",
            "telephone_number": "415-650-6261",
            "fax_number": "415-757-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 FELL ST",
            "address_2": "STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025147",
            "telephone_number": "415-650-6261",
            "fax_number": "415-757-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESAR",
        "first_name": "AKHILA ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "25015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.