Healthcare Provider Details

I. General information

NPI: 1134050073
Provider Name (Legal Business Name): THOMAS RUFINO DE LA CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E 6TH ST APT 317
OXNARD CA
93030-7930
US

IV. Provider business mailing address

217 E 6TH ST APT 317
OXNARD CA
93030-7930
US

V. Phone/Fax

Practice location:
  • Phone: 805-479-8624
  • Fax:
Mailing address:
  • Phone: 805-479-8624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: