Provider Demographics
NPI:1275924557
Name:O'BRIEN, TIMOTHY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:O'BRIEN
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Gender:M
Credentials:PHD
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Mailing Address - Street 1:1 MEDICAL PLAZA DRIVE
Mailing Address - Street 2:UC IRVINE DEPARTMENT OF NEUROLOGY, GOTTSCHALK MEDICAL P
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92697
Mailing Address - Country:US
Mailing Address - Phone:949-824-1264
Mailing Address - Fax:949-824-6202
Practice Address - Street 1:1 MEDICAL PLAZA DRIVE
Practice Address - Street 2:UC IRVINE DEPARTMENT OF NEUROLOGY, GOTTSCHALK MEDICAL P
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697
Practice Address - Country:US
Practice Address - Phone:949-824-1264
Practice Address - Fax:949-824-6202
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2016-01-05
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Provider Licenses
StateLicense IDTaxonomies
CAPSY26611103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical