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General NPI Number Information
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NPI Number | 1881209351
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Entity Type | Individual
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Provider Name | CAROLE ONEIL PHD ORDAINED CLERGY
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 7373 UNIVERSITY AVE STE 201
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City | LA MESA
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State | CA
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Zip | 91942-0524
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Country | US
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Telephone | 619-825-8388
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Fax | 619-825-6878
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Provider Business Mailing Address
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Address Line | 7373 UNIVERSITY AVE STE 201
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City | LA MESA
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State | CA
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Zip | 91942-0524
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Country | US
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Telephone | 619-825-8388
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Fax | 619-825-6878
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5579599735
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 104922
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number | 104922
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 182820120
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License Number State | CA
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