Provider Demographics
NPI:1144530650
Name:O'CONNELL, REBECCA ANNE (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:O'CONNELL
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 1:23151 VERDUGO DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1349
Mailing Address - Country:US
Mailing Address - Phone:949-424-4436
Mailing Address - Fax:
Practice Address - Street 1:23151 VERDUGO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1349
Practice Address - Country:US
Practice Address - Phone:949-424-4436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51813106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist