Healthcare Provider Details

I. General information

NPI: 1154528677
Provider Name (Legal Business Name): ADRIENNE G. LOSTAUNAU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W GONZALES RD SUITE 102 A
OXNARD CA
93036-3303
US

IV. Provider business mailing address

3817 SUNSET LN
OXNARD CA
93035-4135
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-4430
  • Fax: 805-604-4436
Mailing address:
  • Phone: 805-815-3143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS6900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: