Provider Demographics
NPI:1104026954
Name:O'NEILL, DEVON BERKHEISER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:BERKHEISER
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:DEVON
Other - Middle Name:
Other - Last Name:BERKHEISER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 90247
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92169-2247
Mailing Address - Country:US
Mailing Address - Phone:858-337-1213
Mailing Address - Fax:
Practice Address - Street 1:3790 VIA DE LA VALLE
Practice Address - Street 2:SUITE 118E
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4247
Practice Address - Country:US
Practice Address - Phone:858-337-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25621103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist