Edward Oklan, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

G027561 Issued in CA

Practice address

454 Las Gallinas Ave
Ste. 289
San Rafael, CA 94903-3618

Phone

(415) 453-1797

Fax

(415) 453-0985

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 16, 2016 through May 16, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1083677686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 LAS GALLINAS AVE",
            "address_2": "STE. 289",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033618",
            "telephone_number": "415-453-1797",
            "fax_number": "415-453-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 LAS GALLINAS AVE",
            "address_2": "STE. 289",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033618",
            "telephone_number": "415-453-1797",
            "fax_number": "415-453-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKLAN",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G027561",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G027561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ochoa
• Cody Elizabeth-Berry Oeser
• Michelle C. Ogle, LMFT
• Lauren Ashley Ogren, M.A., MFT, LPCCI
• Olaleka Joseph Oguntoba
• Danielle Leslie Okun, L.AC.
• Chiamaka Okwu
• Kenneth Gene Olcott, MFT
• Nancy Williams Olesen, PH.D.
• Rosemary Judith Olive, RN, MSN, CNS

• Child & Adolescent Psychiatry Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.