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General NPI Number Information
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NPI Number | 1083332803
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Entity Type | Organization
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Legal Business Name | OCTAVE BEHAVIORAL PA
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 211 E 7TH ST STE 620
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City | AUSTIN
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State | TX
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Zip | 78701-3218
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Country | US
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Telephone | 415-360-3878
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Fax | 628-234-3087
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Provider Business Mailing Address
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Address Line | 625 MARKET ST FL 15
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-3316
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Country | US
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Telephone | 415-360-3861
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Fax | 628-234-3076
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Authorized Official
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Title or Position | VP, REVENUE OPERATIONS
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Name | KYM EVERETT
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Credential |
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Telephone | 415-360-3861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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