Healthcare Provider Details

I. General information

NPI: 1417769530
Provider Name (Legal Business Name): HEATHER OHARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SARGENT CT
MONTEREY CA
93940-3115
US

IV. Provider business mailing address

157 SARGENT CT
MONTEREY CA
93940-3115
US

V. Phone/Fax

Practice location:
  • Phone: 757-969-0061
  • Fax:
Mailing address:
  • Phone: 757-969-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: