Healthcare Provider Details

I. General information

NPI: 1437405867
Provider Name (Legal Business Name): STEFANIE MORUA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST STE D
OXNARD CA
93033-4574
US

IV. Provider business mailing address

2500 S C ST STE D
OXNARD CA
93033-4574
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-9460
  • Fax:
Mailing address:
  • Phone: 805-385-9460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberIMF67433
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT100513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: