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NPI Code Detail

MEDICARE: VI O'CONNOR LMFT

MEDICARE: VI O'CONNOR LMFT
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
1106H00000XMarriage & Family Therapist121897CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992114391
Entity Type Code : Individual
Provider Name (Legal Business Name) : VI O'CONNOR LMFT
Provider Business Mailing Address
First Line : 5252 BALBOA AVE STE 408
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-6939
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5252 BALBOA AVE STE 408
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-6939
Country : US
Telephone Number : 858-333-6856
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2014
Last Update Date : 10/05/2021

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Directions to “ VI O'CONNOR LMFT” Practice Location

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