Provider Demographics
NPI:1104268127
Name:O'DONNELL, KATHARINE (MSW)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 CHABOT RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1921
Mailing Address - Country:US
Mailing Address - Phone:415-642-5968
Mailing Address - Fax:
Practice Address - Street 1:6925 CHABOT RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1921
Practice Address - Country:US
Practice Address - Phone:415-642-5968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor