Healthcare Provider Details

I. General information

NPI: 1235682253
Provider Name (Legal Business Name): NICHOLAS FERREIRA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 160
OXNARD CA
93036-2612
US

IV. Provider business mailing address

621 GARONNE ST
OXNARD CA
93036-5315
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-6830
  • Fax:
Mailing address:
  • Phone: 661-993-6470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: