Healthcare Provider Details

I. General information

NPI: 1023620374
Provider Name (Legal Business Name): ELLA O'CONNELL CAESTECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16800 ASTON STE 175
IRVINE CA
92606-4820
US

IV. Provider business mailing address

16800 ASTON STE 175
IRVINE CA
92606-4820
US

V. Phone/Fax

Practice location:
  • Phone: 619-489-7035
  • Fax:
Mailing address:
  • Phone: 847-217-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: