Healthcare Provider Details

I. General information

NPI: 1770408908
Provider Name (Legal Business Name): PATRICIA ANN GONWA WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA ANN FOX LMFT

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 CAMINO TOLUCA
CAMARILLO CA
93010-2663
US

IV. Provider business mailing address

1591 SAUSALITO DR
CAMARILLO CA
93010-9203
US

V. Phone/Fax

Practice location:
  • Phone: 805-279-0855
  • Fax:
Mailing address:
  • Phone: 805-279-0855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number28406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: