Provider Demographics
NPI:1225382500
Name:MCCONNELL, MEGAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 S CALIFORNIA AVE
Mailing Address - Street 2:SUITE #14
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1643
Mailing Address - Country:US
Mailing Address - Phone:650-614-0014
Mailing Address - Fax:
Practice Address - Street 1:366 S CALIFORNIA AVE
Practice Address - Street 2:SUITE #14
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1643
Practice Address - Country:US
Practice Address - Phone:650-614-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28707103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist