BRAVE SPACE THERAPY INC
NPI 1346940491
Psychologist - Clinical in Oakland, CA
About Brave Space Therapy Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRAVE SPACE THERAPY INC (NPI 1346940491) is a healthcare organization registered as a clinical in Oakland, California and active in the NPI registry since March 2023. The organization lists Roni Khol, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brave Space Therapy Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Brave Space Therapy Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Brave Space Therapy Inc's NPI number?
The NPI number for Brave Space Therapy Inc is 1346940491. It was assigned to this organization in the NPPES registry on March 7, 2023.
Where is Brave Space Therapy Inc located?
Brave Space Therapy Inc is located at 2220 Mountain Blvd Ste 240, Oakland, CA 94611. The listed phone number is (510) 500-5470.
What is Brave Space Therapy Inc's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Brave Space Therapy Inc enrolled in Medicare?
Yes. Brave Space Therapy Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Brave Space Therapy Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Clinical Psychologist, reassign their Medicare billing to Brave Space Therapy Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Brave Space Therapy Inc was last updated on September 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Brave Space Therapy Inc · NPI 1346940491
Clinical organization in Oakland, California. Organization record, active in the CMS NPPES registry since March 7, 2023.
## Identity
- **NPI:** 1346940491 (Entity type: Organization)
- **Enumerated:** March 7, 2023
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Roni Khol, OWNER
## Practice location
- **Address:** 2220 MOUNTAIN BLVD STE 240, Oakland, CA 94611-2905
- **Phone:** (510) 500-5470
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Clinical Psychologist) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1346940491) · Data from the CMS NPPES public registry.