Healthcare Provider Details

I. General information

NPI: 1023425303
Provider Name (Legal Business Name): ERIN OKRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 09/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S BASCOM AVE
SAN JOSE CA
95128-2601
US

IV. Provider business mailing address

650 S BASCOM AVE
SAN JOSE CA
95128-2601
US

V. Phone/Fax

Practice location:
  • Phone: 408-283-8555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: