Provider Demographics
NPI:1841043726
Name:O'NEIL, MELINDA (MA, APCC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MA, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 BERNAL AVE APT F
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-1125
Mailing Address - Country:US
Mailing Address - Phone:510-274-1647
Mailing Address - Fax:
Practice Address - Street 1:10 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2451
Practice Address - Country:US
Practice Address - Phone:650-458-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health