Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CATC O1012101852 | CA |
N | 101YP1600X | Pastoral Counselor | BCPCC 0318 | VA |
N | 101YS0200X | School Counselor | R51A-BPPS-120047281 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | M-RAS O1012101852 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | LEP 2480 | CA |
Y | 103TB0200X | Cognitive & Behavioral Psychologist | LEP 2480 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | LEP 2480 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | LEP 2480 | CA |
N | 103TS0200X | School Psychologist | R513-SP2-120047281 | CA |
N | 1041S0200X | School Social Worker | R51A-BPPS-120047281 | CA |
NPI | 1194197343 |
---|---|
Provider Name | Dr. Henry Spencer Oneal |
First Address | Victorville, CA 92395-5871 |
Second Address | Victorville, CA 92395-5871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2015 |
Last Update Date | 28/10/2015 |