Healthcare Provider Details

I. General information

NPI: 1801244520
Provider Name (Legal Business Name): TARRA ORAVEC LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39199 LIBERTY ST BUILDING B, ROOM 118
FREMONT CA
94538
US

IV. Provider business mailing address

766 LOMA PRIETA DR
APTOS CA
95003-5518
US

V. Phone/Fax

Practice location:
  • Phone: 510-791-4000
  • Fax:
Mailing address:
  • Phone: 724-994-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0200200
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: