Provider Demographics
NPI:1215438296
Name:O'CONNELL, MEGAN (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 ALMADEN BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1827
Mailing Address - Country:US
Mailing Address - Phone:510-908-0592
Mailing Address - Fax:
Practice Address - Street 1:2442 ALMADEN BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1827
Practice Address - Country:US
Practice Address - Phone:510-908-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician