Provider Demographics
NPI:1154458644
Name:OSHIRO-FOSSATI, PAMELA (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:OSHIRO-FOSSATI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020
Mailing Address - Country:US
Mailing Address - Phone:408-842-7138
Mailing Address - Fax:408-842-0757
Practice Address - Street 1:6980 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-842-7138
Practice Address - Fax:408-842-0757
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS268761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical