Healthcare Provider Details

I. General information

NPI: 1679466544
Provider Name (Legal Business Name): EMILY OTELSBERG ED.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S LOMITA AVE
OJAI CA
93023-2221
US

IV. Provider business mailing address

545 CHESAPEAKE PL
VENTURA CA
93004-3785
US

V. Phone/Fax

Practice location:
  • Phone: 805-640-4300
  • Fax:
Mailing address:
  • Phone: 805-453-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: