Provider Demographics
NPI:1881715712
Name:O'NEAL-PAYNE, TERESA A (LMFT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:O'NEAL-PAYNE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WHEELER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3220
Mailing Address - Country:US
Mailing Address - Phone:626-485-7446
Mailing Address - Fax:
Practice Address - Street 1:125 WHEELER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3220
Practice Address - Country:US
Practice Address - Phone:626-485-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44907106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist