Provider Demographics
NPI:1497063028
Name:ONEAL, LYNNE ELIZABETH (CAADE)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:ELIZABETH
Last Name:ONEAL
Suffix:
Gender:F
Credentials:CAADE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 ADMIRALTY LN
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2217
Mailing Address - Country:US
Mailing Address - Phone:650-286-1661
Mailing Address - Fax:
Practice Address - Street 1:1049 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2822
Practice Address - Country:US
Practice Address - Phone:415-487-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101575324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility