Healthcare Provider Details

I. General information

NPI: 1326838285
Provider Name (Legal Business Name): JUAN DE DIOS TOLEDO SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SIMON WAY
OXNARD CA
93036
US

IV. Provider business mailing address

600 SIMON WAY
OXNARD CA
93036
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-3121
  • Fax:
Mailing address:
  • Phone: 805-485-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number23012814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: