Provider Demographics
NPI:1619209087
Name:O'TOOLE, CHRISTOPHER PATRICK
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:O'TOOLE
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 1:218 E COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1911
Mailing Address - Country:US
Mailing Address - Phone:714-992-4770
Mailing Address - Fax:
Practice Address - Street 1:218 E COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1911
Practice Address - Country:US
Practice Address - Phone:714-992-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)