Healthcare Provider Details

I. General information

NPI: 1275114498
Provider Name (Legal Business Name): EMILY EL-OQLAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6239 COLLEGE AVE STE 303
OAKLAND CA
94618-1384
US

IV. Provider business mailing address

2108 N ST # 6721
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 510-239-3882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY34061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: