Healthcare Provider Details

I. General information

NPI: 1487719928
Provider Name (Legal Business Name): LORI JO ONO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST KAISER - MENTAL HEALTH DEPARTMENT
WALNUT CREEK CA
94596-5318
US

IV. Provider business mailing address

1425 S MAIN ST KAISER - MENTAL HEALTH DEPARTMENT
WALNUT CREEK CA
94596-5318
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-6487
  • Fax: 925-295-5226
Mailing address:
  • Phone: 925-295-6487
  • Fax: 925-295-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY18140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: