Provider Demographics
NPI:1235787029
Name:ONEILL, KIERRAN NICOLE (APCC)
Entity Type:Individual
Prefix:MS
First Name:KIERRAN
Middle Name:NICOLE
Last Name:ONEILL
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3631 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6951
Mailing Address - Country:US
Mailing Address - Phone:657-356-6490
Mailing Address - Fax:657-356-6290
Practice Address - Street 1:3631 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6951
Practice Address - Country:US
Practice Address - Phone:657-356-6490
Practice Address - Fax:657-356-6290
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14288101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor