| Doctor Name: | MR. JOSEPH R. COLELLA |
| NPI Number: | 1255587960 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CAADE/AOD INTERN |
| License Number: | |
| Business Practice Address: | 225 Cabrillo Hwy S #200a Half Moon Bay, CA - 940198200 |
| Business Phone Number: | 6507266369 |
| Business Fax Number: | 6507264963 |
| Mailing Address: | Po Box 353, EL GRANADA |
| State: | CA |
| Postal Code: | 940180353 |
| Phone Number: | 6507263149 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2008 |
| NPI Last Update Date: | 08/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |