Provider Demographics
NPI:1982171716
Name:OKONSKI, MICHELE ALAYNE (PSYD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ALAYNE
Last Name:OKONSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5543
Mailing Address - Country:US
Mailing Address - Phone:805-358-1711
Mailing Address - Fax:
Practice Address - Street 1:92 ARGONAUT
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4116
Practice Address - Country:US
Practice Address - Phone:949-682-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16250103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist