Brave Space Therapy Inc
NPI 1346940491ActiveOrganization· Psychologist, Clinical· Oakland, CA
Psychologist, Clinical in Oakland, California, registered in NPPES in March 2023. The authorized official on file is Roni Khol, PSY.D, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1346940491 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 7, 2023 |
| Last updated in NPPES | Sep 7, 2025 |
| Certified by provider | Sep 7, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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