Healthcare Provider Details

I. General information

NPI: 1306784814
Provider Name (Legal Business Name): LIFELINK PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 STATHAM BLVD
OXNARD CA
93033-3908
US

IV. Provider business mailing address

1981 S VICTORIA AVE
VENTURA CA
93003-6616
US

V. Phone/Fax

Practice location:
  • Phone: 805-830-2177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ARUNI GANEWATTE
Title or Position: CEO
Credential:
Phone: 818-644-9665