Healthcare Provider Details

I. General information

NPI: 1063097855
Provider Name (Legal Business Name): VANESSA PILAR PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 VENTURA BLVD STE 126
OXNARD CA
93036-0277
US

IV. Provider business mailing address

18726 S WESTERN AVE
GARDENA CA
90248-3813
US

V. Phone/Fax

Practice location:
  • Phone: 805-794-1265
  • Fax:
Mailing address:
  • Phone: 310-856-0800
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2830281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: