Healthcare Provider Details

I. General information

NPI: 1679361117
Provider Name (Legal Business Name): ALEXANDRIA WHEADON PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N VENTURA RD
OXNARD CA
93036-2272
US

IV. Provider business mailing address

3213 N VENTURA RD
OXNARD CA
93036-5361
US

V. Phone/Fax

Practice location:
  • Phone: 805-307-0080
  • Fax:
Mailing address:
  • Phone: 805-263-9834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: