Healthcare Provider Details

I. General information

NPI: 1295498285
Provider Name (Legal Business Name): MARIA-BLESSILDA VILLARIN CABANBAN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
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: 805-385-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: