Provider Demographics
NPI:1508562182
Name:OCONNOR, SEAMUS NMN
Entity Type:Individual
Prefix:
First Name:SEAMUS
Middle Name:NMN
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1762 N FOREST OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-8563
Mailing Address - Country:US
Mailing Address - Phone:760-569-7545
Mailing Address - Fax:
Practice Address - Street 1:1762 N FOREST OAKS DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-8563
Practice Address - Country:US
Practice Address - Phone:760-569-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT5383106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist