Provider Demographics
NPI:1598098105
Name:DELAURIER-O'NEIL, ALICE (NP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:DELAURIER-O'NEIL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W SCHULTE RD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-9176
Mailing Address - Country:US
Mailing Address - Phone:209-598-1562
Mailing Address - Fax:
Practice Address - Street 1:530 W EATON AVE
Practice Address - Street 2:SUITE K
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3400
Practice Address - Country:US
Practice Address - Phone:209-835-4232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA260127363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care