Healthcare Provider Details

I. General information

NPI: 1326942749
Provider Name (Legal Business Name): PETER TUSSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAMINO DEL SOL STE 23
OXNARD CA
93030-3725
US

IV. Provider business mailing address

752 S SATICOY AVE
VENTURA CA
93004-1819
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-3636
  • Fax:
Mailing address:
  • Phone: 805-575-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: