Healthcare Provider Details

I. General information

NPI: 1174763288
Provider Name (Legal Business Name): RAENA DAY WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

IV. Provider business mailing address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-5441
  • Fax:
Mailing address:
  • Phone: 805-981-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberW0807100832
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number67037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: