Healthcare Provider Details

I. General information

NPI: 1083135370
Provider Name (Legal Business Name): PHINETTE TAMAR NORTON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 120
OXNARD CA
93036-2612
US

IV. Provider business mailing address

1411 AMBROSE AVE
OXNARD CA
93035-3302
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-9270
  • Fax:
Mailing address:
  • Phone: 805-832-3699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number98449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: