Healthcare Provider Details

I. General information

NPI: 1366592529
Provider Name (Legal Business Name): CAROLINE KIEMI OKANO M.A., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

747 52ND ST
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 510-708-3226
  • Fax:
Mailing address:
  • Phone: 510-708-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT81804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: