Provider Demographics
NPI:1558498485
Name:O'CONNELL, AURELIA MACABASCO (PHD, ACNP)
Entity Type:Individual
Prefix:DR
First Name:AURELIA
Middle Name:MACABASCO
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PHD, ACNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:25560 PRADO DE LAS BELLOTAS
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3632
Mailing Address - Country:US
Mailing Address - Phone:310-405-9836
Mailing Address - Fax:310-794-7482
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1437
Practice Address - Country:US
Practice Address - Phone:310-405-9836
Practice Address - Fax:310-794-7482
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA451303363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care