1932306248 NPI number — ANNA KATHERINE O'CONNOR MSW, LCSW

Table of content: ANNA KATHERINE O'CONNOR MSW, LCSW (NPI 1932306248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932306248 NPI number — ANNA KATHERINE O'CONNOR MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'CONNOR
Provider First Name:
ANNA
Provider Middle Name:
KATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KURTZ
Provider Other First Name:
ANNA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932306248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1340 ARNOLD DRIVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MARTINEZ
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-957-5109
Provider Business Mailing Address Fax Number:
925-957-5156

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1340 ARNOLD DRIVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MARTINEZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-957-5109
Provider Business Practice Location Address Fax Number:
925-957-5156
Provider Enumeration Date:
06/29/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  18712 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LCSW78449 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)