Provider Demographics
NPI:1215031745
Name:O'CONNOR, MEGAN EILEEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:EILEEN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:EILEEN
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:751 CARMEL AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3223
Mailing Address - Country:US
Mailing Address - Phone:650-861-0724
Mailing Address - Fax:
Practice Address - Street 1:795 WILLOW RD
Practice Address - Street 2:BLDG 331 NHCU
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-2539
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist