Healthcare Provider Details

I. General information

NPI: 1427482405
Provider Name (Legal Business Name): SARAH J OU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MOORPARK AVE SUITE 300
SAN JOSE CA
95128-2631
US

IV. Provider business mailing address

2150 PORTOLA AVE. SUITE D #184
LIVERMORE CA
94551
US

V. Phone/Fax

Practice location:
  • Phone: 408-975-2730
  • Fax:
Mailing address:
  • Phone: 510-891-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number79893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: