Healthcare Provider Details

I. General information

NPI: 1568885564
Provider Name (Legal Business Name): LUSETTE OKADA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DEL NORTE DR
SAN BRUNO CA
94066-2508
US

IV. Provider business mailing address

140 DEL NORTE DR
SAN BRUNO CA
94066-2508
US

V. Phone/Fax

Practice location:
  • Phone: 650-443-6627
  • Fax:
Mailing address:
  • Phone: 650-443-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS29661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: