Healthcare Provider Details

I. General information

NPI: 1275990822
Provider Name (Legal Business Name): RUTH CONTRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date: 07/23/2018
Reactivation Date: 08/28/2018

III. Provider practice location address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

IV. Provider business mailing address

424 WALNUT DR
OXNARD CA
93036-1323
US

V. Phone/Fax

Practice location:
  • Phone: 805-890-7154
  • Fax:
Mailing address:
  • Phone: 805-890-7154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW122817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: