Ola Fuller Bennett, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 5778 Issued in CA

Practice address

3007 Telegraph Ave
Oakland, CA 94609-3205

Phone

(510) 433-1500

Fax

(510) 433-1500

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• The West Oakland Health Council

  • Public Health or Welfare Agency
  • Oakland, CA
  • NPI 1073769402
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154522159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 HARDING WAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021920",
            "telephone_number": "510-433-1500",
            "fax_number": "510-433-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093205",
            "telephone_number": "510-433-1500",
            "fax_number": "510-433-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "OLA",
        "middle_name": "FULLER",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 5778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORK",
            "identifier": "LSC5778",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damon Randolph Bennett, LCSW
• Daniel Bennett
• Debra Ann Bennett
• Dwayne A Bennett Sr.
• Kylie A Bennett
• Oriana Marie Bennett
• Richard Joseph Bennett, R.D.
• Romaine Marie Bennett, ARNP
• Shenay Bennett, PEER SUPPORT SPECIAL
• Yan Bennis

• 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 Jul 8, 2007; 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.