Provider Demographics
NPI:1063645976
Name:O'DONNELL, TRISHA (ND)
Entity Type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6361
Mailing Address - Country:US
Mailing Address - Phone:858-964-4548
Mailing Address - Fax:
Practice Address - Street 1:3945 STANFORD DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-6361
Practice Address - Country:US
Practice Address - Phone:858-964-4548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000804175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath