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General NPI Number Information
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NPI Number | 1538324033
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Entity Type | Individual
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Provider Name | KEVEN PATRICK O'BRIEN
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Gender | Male
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 275 BAKER ST E SUITE A
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City | COSTA MESA
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State | CA
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Zip | 92626-4566
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Country | US
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Telephone | 714-361-6760
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Fax | 714-361-6768
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Provider Business Mailing Address
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Address Line | 1910 N BUSH ST
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City | SANTA ANA
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State | CA
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Zip | 92706-2816
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Country | US
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Telephone | 714-361-7950
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Fax | 714-361-7966
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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