Individual provider Active NPI

Timothy O'Connell, CATC

  • Addiction (Substance Use Disorder) Counselor
  • Cardiff, CA
National Provider Identifier
1972040061
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
19609 Issued in CA
Practice address
120 Birmingham Dr Ste 240a
Cardiff, CA 92007-1757
Phone
(858) 208-0121
NPI assigned
Jan 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19609 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2114485 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X
Peer Specialist 175T00000X

Addresses

Primary practice location

120 Birmingham Dr Ste 240a
Cardiff, CA 92007-1757

Mailing address

10281 Kidd St
Riverside, CA 92503-3469
Phone (951) 715-5050

Other practice location 1

14677 Merrill Ave
Fontana, CA 92335-4219
Phone (951) 643-2340

Other practice location 2

2085 Rustin Ave Bldg 1
Riverside, CA 92507-2498
Phone (951) 782-2400

Other practice location 3

17830 Arrow Blvd
Fontana, CA 92335-4037
Phone (909) 356-6730

Other practice location 4

10281 Kidd St
Riverside, CA 92503-3469
Phone (951) 715-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2114485CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Jan 5, 2025 Accepting new patients
Alondra Loya Case Manager/Care Coordinator CurrentSince Jun 15, 2025 Accepting new patients

Locations

14677 Merrill Ave
Fontana, CA 92335
Phone (951) 643-2335

10281 Kidd St
Riverside, CA 92503
Phone (951) 358-5785

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1972040061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10281 KIDD ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033469",
            "telephone_number": "951-715-5050",
            "fax_number": "800-498-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BIRMINGHAM DR STE 240A",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071757",
            "telephone_number": "858-208-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14677 Merrill Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923354219",
            "country_code": "US",
            "telephone_number": "951-643-2340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2085 Rustin Ave Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072498",
            "country_code": "US",
            "telephone_number": "951-782-2400",
            "fax_number": "951-784-9176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17830 Arrow Blvd",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923354037",
            "country_code": "US",
            "telephone_number": "909-356-6730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10281 Kidd St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033469",
            "country_code": "US",
            "telephone_number": "951-715-5050",
            "fax_number": "800-498-8847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "TIMOTHY",
        "credential": "CATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-26",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "19609",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "2114485",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cardiff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.