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NPI Code Detail

MEDICARE: TATIANA ROSE OMOLO ASW

MEDICARE: TATIANA ROSE OMOLO ASW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker124871CA

General Provider Information

NPI Number : 1558181016
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATIANA ROSE OMOLO ASW
Provider Business Mailing Address
First Line : 1430 WILLOW PASS RD STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-7946
Country : US
Telephone Number : 925-288-3900
Fax Number :
Provider Business Practice Location Address
First Line : 1430 WILLOW PASS RD STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-7946
Country : US
Telephone Number : 925-288-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2024
Last Update Date : 03/02/2026

Similar Medicare Providers

1629106778 — MS. NATALIE DIMIDJIAN LCSW
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-313-9554
Practice Fax:
1407037468 — MRS. JENNIFER LEWIS LCSW
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-288-3900
Practice Fax:
1487818803 — MR. JAMES LANCASTER LMFT
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-288-3926
Practice Fax: 925-646-5774
1114174877 — DR. AMANDA BETH ELDER PSYD
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-288-3907
Practice Fax: 925-646-5774
1043522261 — MS. SOOJUNG HAN LCSW
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-510-3000
Practice Fax:
1609155316 — CRAIG THOMAS VAN DYKE LMFT
Practice Location Address:
1430 WILLOW PASS RD STE 100
CONCORD, CA
94520-7946
Practice Phone: 925-288-3900
Practice Fax: 925-646-5774

Directions to “ TATIANA ROSE OMOLO ASW” Practice Location

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