Healthcare Provider Details

I. General information

NPI: 1679497994
Provider Name (Legal Business Name): CARLEIGH ANN OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 S LEWIS RD
CAMARILLO CA
93012-8520
US

IV. Provider business mailing address

2537 VERDA CT
SIMI VALLEY CA
93065-2349
US

V. Phone/Fax

Practice location:
  • Phone: 805-702-2930
  • Fax: 805-384-5782
Mailing address:
  • Phone: 805-297-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: