1295566743 NPI number — CHELSEA ALI O'NEILL ACSW

Table of content: CHELSEA ALI O'NEILL ACSW (NPI 1295566743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295566743 NPI number — CHELSEA ALI O'NEILL ACSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'NEILL
Provider First Name:
CHELSEA
Provider Middle Name:
ALI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ACSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295566743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5939 SOUTH ST APT 22
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90713-1341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-831-2209
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-991-9616
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  ASW105937 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)