Healthcare Provider Details

I. General information

NPI: 1366352585
Provider Name (Legal Business Name): OSITO, LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 FAMILY TREE
IRVINE CA
92618-1067
US

IV. Provider business mailing address

723 FAMILY TREE
IRVINE CA
92618-1067
US

V. Phone/Fax

Practice location:
  • Phone: 504-329-5248
  • Fax:
Mailing address:
  • Phone: 504-329-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIA ELIZABETH BROTHERSTON
Title or Position: CEO
Credential: MSW, LCSW
Phone: 949-414-4768