Provider Demographics
NPI:1790105450
Name:O'GARA, VICTORIA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:O'GARA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25771 CREAG AVE
Mailing Address - Street 2:
Mailing Address - City:HOMELAND
Mailing Address - State:CA
Mailing Address - Zip Code:92548-9351
Mailing Address - Country:US
Mailing Address - Phone:714-818-8319
Mailing Address - Fax:
Practice Address - Street 1:117 E HARRY BRIDGES BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5825
Practice Address - Country:US
Practice Address - Phone:310-549-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)