Healthcare Provider Details

I. General information

NPI: 1205947116
Provider Name (Legal Business Name): MS. ERIN OSHAUGHNESSY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 NE WILLIAMS AVE
DEPOE BAY OR
97341-1979
US

IV. Provider business mailing address

23 NE WILLIAMS AVE
DEPOE BAY OR
97341-1979
US

V. Phone/Fax

Practice location:
  • Phone: 831-917-2221
  • Fax:
Mailing address:
  • Phone: 831-917-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT17670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: