Healthcare Provider Details

I. General information

NPI: 1285497727
Provider Name (Legal Business Name): MRS. ONYX ONASIN PACHECO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 FULTON ST
CAMARILLO CA
93010-6545
US

IV. Provider business mailing address

314 W 4TH ST
OXNARD CA
93030-5910
US

V. Phone/Fax

Practice location:
  • Phone: 805-419-4863
  • Fax:
Mailing address:
  • Phone: 805-382-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number560091AP
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: