Provider Demographics
NPI:1447561089
Name:O'NEILL, KIMBERLY HO (MSPT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:HO
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9961 SIERRA AVE
Mailing Address - Street 2:MOB #2 - 6TH FLOOR
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6720
Mailing Address - Country:US
Mailing Address - Phone:909-427-4582
Mailing Address - Fax:909-427-5282
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:MOB #2 - 6TH FLOOR
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-4582
Practice Address - Fax:909-427-5282
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist