Healthcare Provider Details

I. General information

NPI: 1801706122
Provider Name (Legal Business Name): ANA O'NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N HAPPY VALLEY RD
NAMPA ID
83687-8589
US

IV. Provider business mailing address

5530 E VICTORIA FALLS DR
NAMPA ID
83686-1032
US

V. Phone/Fax

Practice location:
  • Phone: 208-831-2273
  • Fax:
Mailing address:
  • Phone: 310-504-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number6811095
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: