Healthcare Provider Details

I. General information

NPI: 1114885670
Provider Name (Legal Business Name): SAMANTHA ECHEVARRIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAMINO DEL SOL STE 1
OXNARD CA
93030-3725
US

IV. Provider business mailing address

1666 SAN NICHOLAS ST APT A
VENTURA CA
93001-3367
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-5437
  • Fax:
Mailing address:
  • Phone: 661-577-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW136071
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: