Provider Demographics
NPI:1376060517
Name:O'CONNELL, PAIGE ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:ELIZABETH
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 KEITH DR
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3667
Mailing Address - Country:US
Mailing Address - Phone:707-339-8488
Mailing Address - Fax:
Practice Address - Street 1:16 KEITH DR
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3667
Practice Address - Country:US
Practice Address - Phone:707-339-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31769103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist