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General NPI Number Information
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NPI Number | 1174049969
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Entity Type | Individual
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Provider Name | CARRIE O'LEARY MA
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 15814 WINCHESTER BLVD STE 102
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City | LOS GATOS
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State | CA
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Zip | 95030-3333
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Country | US
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Telephone | 408-717-3105
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Fax |
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Provider Business Mailing Address
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Address Line | 19161 LOREE AVE
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City | CUPERTINO
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State | CA
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Zip | 95014-3539
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Country | US
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Telephone | 408-717-3105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 125887
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License Number State | CA
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