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Organization
MYSAFESPACE PROFESSIONAL INC: A PSYCHOLOGY CORPORATION
Active
Organization
MYSAFESPACE PROFESSIONAL INC: A PSYCHOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENOWOGHOMWENMA OSAGHAE (CLINICAL DIRECTOR)
(415) 237-3598
Entity
Organization
Contact information
Practice address
1615 POLK ST STE 3, SAN FRANCISCO, CA 94109-3698
(415) 237-3598
(628) 388-3011
Mailing address
5432 GEARY BLVD UNIT 694, SAN FRANCISCO, CA 94121-2307
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
04/26/2024
Last updated
10/03/2024
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