Provider Demographics
NPI:1063614196
Name:FUNES, WILLIAM O
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:O
Last Name:FUNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 MORGAN WAY
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-1525
Mailing Address - Country:US
Mailing Address - Phone:714-929-9415
Mailing Address - Fax:
Practice Address - Street 1:4343 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2803
Practice Address - Country:US
Practice Address - Phone:562-427-6860
Practice Address - Fax:562-427-2058
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health