Provider Demographics
NPI:1891825030
Name:MCFADDEN, CONNOR (MA, IMF)
Entity Type:Individual
Prefix:MR
First Name:CONNOR
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:MA, IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 JUNIPER AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-8259
Mailing Address - Country:US
Mailing Address - Phone:619-987-2668
Mailing Address - Fax:
Practice Address - Street 1:1919 APPLE ST STE A B
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-4443
Practice Address - Country:US
Practice Address - Phone:760-439-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health