Provider Demographics
NPI:1538209218
Name:O'BRIEN, MERRILEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:MERRILEE
Middle Name:
Last Name:O'BRIEN
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:PO BOX 1596
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-1596
Mailing Address - Country:US
Mailing Address - Phone:310-257-5776
Mailing Address - Fax:310-257-5753
Practice Address - Street 1:3333 SKYPARK DR
Practice Address - Street 2:220
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5023
Practice Address - Country:US
Practice Address - Phone:310-257-5776
Practice Address - Fax:310-257-5753
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health