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General NPI Number Information
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NPI Number | 1508582677
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Entity Type | Individual
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Provider Name | KELSEY ONEIL
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1910 OLYMPIC BLVD STE 365
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City | WALNUT CREEK
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State | CA
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Zip | 94596-5096
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Country | US
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Telephone | 877-676-7634
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Fax |
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Provider Business Mailing Address
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Address Line | 713 DEWITT AVE UNIT A
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City | ENCINITAS
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State | CA
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Zip | 92024-3605
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Country | US
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Telephone | 617-840-1676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 119470
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License Number State | CA
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