Basic Information
| Provider Information | |||||||||
| NPI: | 1689861148 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'NEILL | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8333 CLAIREMONT MESA BLVD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921111318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582688585 | ||||||||
| FaxNumber: | 8582685729 | ||||||||
| Practice Location | |||||||||
| Address1: | 8333 CLAIREMONT MESA BLVD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921111318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582688585 | ||||||||
| FaxNumber: | 8582685729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2007 | ||||||||
| LastUpdateDate: | 09/28/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 001249 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.