Provider Demographics
NPI:1942028097
Name:O'NEILL, JASON (RD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 H ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4730
Mailing Address - Country:US
Mailing Address - Phone:808-371-7995
Mailing Address - Fax:
Practice Address - Street 1:210 H ST APT 2B
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4730
Practice Address - Country:US
Practice Address - Phone:808-371-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered