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NPI Code Detail

MEDICARE: MARIA O'TUEL PSYD

MEDICARE: MARIA O'TUEL PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2694NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2046R4OTHERNCBLUE CROSS BLUE SHIELD
360-00175OTHEREVERCARE

General Provider Information

NPI Number : 1962494328
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA O'TUEL PSYD
Provider Business Mailing Address
First Line : 21545 CENTRE POINTE PKWY
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91350-2947
Country : US
Telephone Number : 661-259-9439
Fax Number :
Provider Business Practice Location Address
First Line : 21545 CENTRE POINTE PKWY
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91350-2947
Country : US
Telephone Number : 661-259-9439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 05/21/2009

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