Provider Demographics
NPI:1023287588
Name:O'HEARN, TODD CHRISTOPHER (PHD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:O'HEARN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MICHELTORENA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6522
Mailing Address - Country:US
Mailing Address - Phone:805-766-0107
Mailing Address - Fax:805-495-6970
Practice Address - Street 1:22 W MICHELTORENA ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6522
Practice Address - Country:US
Practice Address - Phone:805-766-0107
Practice Address - Fax:805-495-6970
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18721103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral