Omar Anthony Bocobo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21511 Issued in CA

Practice address

2579 San Pablo Ave
Oakland, CA 94612-1159

Phone

(510) 446-7110

Fax

(510) 446-7191

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellness Source Psychotherapy and Consulting, a Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Berkeley, CA
  • NPI 1508794207
  NPD Authorized official

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1124069802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2579 SAN PABLO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121159",
            "telephone_number": "510-581-6160",
            "fax_number": "510-581-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 SAN PABLO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121159",
            "telephone_number": "510-446-7110",
            "fax_number": "510-446-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCOBO",
        "first_name": "OMAR",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Florencia Bobino
• Artemisa Bobst, AMFT
• Maria de Jesus Bocanegra
• Hanna Renee Bocian
• Mehzabeen Nisha Bockert
• Sandhya Bodapati
• Shannon Erika Marie Bode, B.A.
• Ethan Emmet Bodle, M.D., M.P.H
• Jennifer S. Bodnick, MD
• Bodyful Physical Therapy and Wellness

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.