Healthcare Provider Details

I. General information

NPI: 1114924230
Provider Name (Legal Business Name): ALAN MASAAKI OOKA APRN, BC, P-MHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23521 PASEO DE VALENCIA SUITE 206A
LAGUNA HILLS CA
92653-3107
US

IV. Provider business mailing address

41 GLENALMOND LN
LADERA RANCH CA
92694-0910
US

V. Phone/Fax

Practice location:
  • Phone: 949-768-6845
  • Fax: 949-768-5124
Mailing address:
  • Phone: 310-621-7359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN 562338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: