Healthcare Provider Details

I. General information

NPI: 1255643037
Provider Name (Legal Business Name): MASAMI OHNUI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 592
GUERNEVILLE CA
95446-0592
US

IV. Provider business mailing address

PO BOX 592
GUERNEVILLE CA
95446-0592
US

V. Phone/Fax

Practice location:
  • Phone: 707-799-5488
  • Fax:
Mailing address:
  • Phone: 707-799-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34946
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: