Healthcare Provider Details

I. General information

NPI: 1003297169
Provider Name (Legal Business Name): ELIZABETH SALDIVAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST STE C
OXNARD CA
93033-4573
US

IV. Provider business mailing address

2500 S C ST STE C
OXNARD CA
93033-4573
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-9420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number38255
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT102771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: