Healthcare Provider Details

I. General information

NPI: 1639627086
Provider Name (Legal Business Name): DOROTHY D O'NEILL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 E CANYON RIM RD STE 215
ANAHEIM CA
92807-4317
US

IV. Provider business mailing address

6200 E CANYON RIM RD STE 215
ANAHEIM CA
92807-4317
US

V. Phone/Fax

Practice location:
  • Phone: 714-928-7974
  • Fax:
Mailing address:
  • Phone: 714-928-7974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT85660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: