Healthcare Provider Details

I. General information

NPI: 1912330879
Provider Name (Legal Business Name): ESTEFANIA ELIZALDE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 120
OXNARD CA
93036-2612
US

IV. Provider business mailing address

1911 WILLIAMS DR STE 120
OXNARD CA
93036-2612
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-9270
  • Fax: 805-981-9271
Mailing address:
  • Phone: 805-981-9270
  • Fax: 805-981-9271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW101461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: