Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brave Space Therapy Inc

Organization Clinical Psychologist · NPI 1346940491

Brave Space Therapy Inc is a Clinical Psychologist in Oakland, California. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2220 Mountain Blvd Ste 240
Oakland, CA 94611-2905
Phone: (510) 500-5470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X

Record details

NPI number1346940491
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roni Khol — Owner · (510) 500-5470
NPI enumeratedMarch 7, 2023
Last updated in NPPESSeptember 7, 2025
Certification dateSeptember 7, 2025
Mailing address5665 College Ave Ste 240e, Oakland, CA 94618-1647

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