Provider Demographics
NPI:1033603980
Name:O'NEIL, JESSE (BCBA)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5201
Mailing Address - Country:US
Mailing Address - Phone:858-750-1576
Mailing Address - Fax:
Practice Address - Street 1:7827 CONVOY CT STE 406
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1218
Practice Address - Country:US
Practice Address - Phone:619-719-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst