Provider Demographics
NPI:1083830723
Name:O'HEARN, HOLLY GARCIA (PHD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:GARCIA
Last Name:O'HEARN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E HILLCREST DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5828
Mailing Address - Country:US
Mailing Address - Phone:805-766-0777
Mailing Address - Fax:
Practice Address - Street 1:325 E HILLCREST DR
Practice Address - Street 2:SUITE 115
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5828
Practice Address - Country:US
Practice Address - Phone:805-766-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18804103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist