Healthcare Provider Details

I. General information

NPI: 1548091341
Provider Name (Legal Business Name): SARA O'CONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 GRAND AVE STE 100
OAKLAND CA
94610-4895
US

IV. Provider business mailing address

298 GRAND AVE STE 100
OAKLAND CA
94610-4895
US

V. Phone/Fax

Practice location:
  • Phone: 510-463-4445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162872
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number22220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: