Healthcare Provider Details

I. General information

NPI: 1609076082
Provider Name (Legal Business Name): ANNE A OLOGBOSELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6361 CLARK AVE
DUBLIN CA
94568-3001
US

IV. Provider business mailing address

6361 CLARK AVE
DUBLIN CA
94568
US

V. Phone/Fax

Practice location:
  • Phone: 925-556-4584
  • Fax:
Mailing address:
  • Phone: 925-556-4584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT129414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: