Provider Demographics
NPI:1629344965
Name:O'BYRNE & ASSOCIATES
Entity Type:Organization
Organization Name:O'BYRNE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:425-686-4459
Mailing Address - Street 1:9 ANA CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3301
Mailing Address - Country:US
Mailing Address - Phone:415-686-4459
Mailing Address - Fax:
Practice Address - Street 1:2175 FRANCISCO BLVD E
Practice Address - Street 2:SUITE L
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5510
Practice Address - Country:US
Practice Address - Phone:415-686-4459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty