Provider Demographics
NPI:1619439080
Name:RUDD, MEGHAN O'NEAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:O'NEAL
Last Name:RUDD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1414
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93024-1414
Mailing Address - Country:US
Mailing Address - Phone:805-804-7742
Mailing Address - Fax:
Practice Address - Street 1:530 W OJAI AVE STE 204
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2472
Practice Address - Country:US
Practice Address - Phone:805-633-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25366103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical