Provider Demographics
NPI:1972993269
Name:OCONNOR, SHEILA K (MFT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:K
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53600 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:AGUANGA
Mailing Address - State:CA
Mailing Address - Zip Code:92536-9222
Mailing Address - Country:US
Mailing Address - Phone:805-795-6543
Mailing Address - Fax:
Practice Address - Street 1:53600 SHORT ST
Practice Address - Street 2:
Practice Address - City:AGUANGA
Practice Address - State:CA
Practice Address - Zip Code:92536-9222
Practice Address - Country:US
Practice Address - Phone:805-795-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT40901106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist