Provider Demographics
NPI:1225212293
Name:SAELIN, MICHELLE CHIEKO (CPRP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHIEKO
Last Name:SAELIN
Suffix:
Gender:F
Credentials:CPRP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:CHIEKO
Other - Last Name:WACHHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPRP
Mailing Address - Street 1:2538 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4704
Mailing Address - Country:US
Mailing Address - Phone:612-567-6900
Mailing Address - Fax:
Practice Address - Street 1:3301 E 12TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601
Practice Address - Country:US
Practice Address - Phone:510-269-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor