MEDICARE: DR. JOEL O'BESO PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY34448	CA

General Provider Information

NPI Number	:	1154566438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL O'BESO PSY.D.

Provider Business Mailing Address
First Line	:	1900 OFARRELL ST STE 100
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1387
Country	:	US
Telephone Number	:	650-780-0575
Fax Number	:	650-780-0587

Provider Business Practice Location Address
First Line	:	1900 OFARRELL ST STE 100
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1387
Country	:	US
Telephone Number	:	650-780-0575
Fax Number	:	650-780-0587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	01/31/2026

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