Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 8300 | CA |
Y | 103T00000X | Psychologist | 8300 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 8300 | CA |
N | 103TC0700X | Clinical Psychologist | 8300 | CA |
N | 103TF0000X | Family Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1336423524 |
---|---|
Provider Name | Dr. Katherine Rosemary O'connell |
First Address | Eureka, CA 95502-6860 |
Second Address | Arcata, CA 95521-6781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 02/05/2017 |