Provider Demographics
NPI:1194197343
Name:ONEAL, HENRY SPENCER (DRAD, LEP, CATC)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:SPENCER
Last Name:ONEAL
Suffix:
Gender:M
Credentials:DRAD, LEP, CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12402 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5871
Mailing Address - Country:US
Mailing Address - Phone:760-486-3855
Mailing Address - Fax:
Practice Address - Street 1:12402 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5871
Practice Address - Country:US
Practice Address - Phone:760-486-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACATC O1012101852101YA0400X
VABCPCC 0318101YP1600X
CAR51A-BPPS-120047281101YS0200X, 1041S0200X
CAM-RAS O1012101852103TA0400X
CALEP 2480103TA0700X, 103TB0200X, 103TC2200X, 103TM1800X
CAR513-SP2-120047281103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool