Provider Demographics
NPI:1720841315
Name:O'KEEFFE, SARINA MARIE
Entity Type:Individual
Prefix:
First Name:SARINA
Middle Name:MARIE
Last Name:O'KEEFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 CHURIN DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4532
Mailing Address - Country:US
Mailing Address - Phone:650-521-7207
Mailing Address - Fax:
Practice Address - Street 1:745 DISTEL DR STE 130
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1523
Practice Address - Country:US
Practice Address - Phone:650-521-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist