MEDICARE: JOSEPH PATRICK O'KEEFE LCSW

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	1041C0700X	Clinical Social Worker	LCS 18346	CA

General Provider Information

NPI Number	:	1760607824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH PATRICK O'KEEFE LCSW

Provider Business Mailing Address
First Line	:	2423 CAMINO DEL RIO S
Second Line	:	STE. 103
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3702
Country	:	US
Telephone Number	:	619-813-5402
Fax Number	:

Provider Business Practice Location Address
First Line	:	7860 MISSION CENTER CT
Second Line	:	STE. 204
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1329
Country	:	US
Telephone Number	:	619-813-5402
Fax Number	:

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	04/17/2013

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