Provider Demographics
NPI:1952113383
Name:OMEARA, CHRISTOPHER ANTHONY (RAD-T)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:OMEARA
Suffix:
Gender:M
Credentials:RAD-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 NATICK AVE UNIT 213
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2774
Mailing Address - Country:US
Mailing Address - Phone:773-351-4922
Mailing Address - Fax:
Practice Address - Street 1:22915 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4203
Practice Address - Country:US
Practice Address - Phone:818-800-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health