Provider Demographics
NPI:1558176446
Name:OKEEFE, TIMOTHY (AMFT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:OKEEFE
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 LAFAYETTE CIR STE 330
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4388
Mailing Address - Country:US
Mailing Address - Phone:510-859-4634
Mailing Address - Fax:
Practice Address - Street 1:251 LAFAYETTE CIR STE 330
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4388
Practice Address - Country:US
Practice Address - Phone:510-859-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149698106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist