Healthcare Provider Details

I. General information

NPI: 1942639034
Provider Name (Legal Business Name): MICHELE O'BRIEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 06/13/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD STE 202
SALINAS CA
93906-3127
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD, BLDG 400, STE 202
SALINAS CA
93906-3127
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1700
  • Fax:
Mailing address:
  • Phone: 831-796-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number85143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: