Provider Demographics
NPI:1518074699
Name:ONEAL MAS, PATTY ANN
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:ONEAL MAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:ANN
Other - Last Name:ONEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2558 ROOSEVELT ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008
Mailing Address - Country:US
Mailing Address - Phone:760-434-9945
Mailing Address - Fax:760-400-0100
Practice Address - Street 1:2558 ROOSEVELT ST
Practice Address - Street 2:SUITE 204 PATTY ONEAL
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:760-434-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29192106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist