Provider Demographics
NPI:1306638606
Name:ULLOA, OKALANI (PPS)
Entity type:Individual
Prefix:MRS
First Name:OKALANI
Middle Name:
Last Name:ULLOA
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 S GIANO AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2400
Mailing Address - Country:US
Mailing Address - Phone:626-506-9324
Mailing Address - Fax:
Practice Address - Street 1:3223 S GIANO AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-2400
Practice Address - Country:US
Practice Address - Phone:626-965-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty