O'Connell, Tim
O'Connell, Tim is an individual health care provider with primary practice located at 14677 Merrill Ave , Fontana CA 92335-4219. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. O'Connell, Tim can be contacted via phone (951) 643-2340.Contact Information
Primary practice address
14677 Merrill Ave
Fontana CA 92335-4219
Phone: (951) 643-2340
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1972040061 |
|---|---|
| LBN Legal business name | O'Connell, Tim |
| Credentials | RADT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2017 |
| Last updated | Sep 21st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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