Healthcare Provider Details

I. General information

NPI: 1386023927
Provider Name (Legal Business Name): JETTA S. ZELLNER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E ESPLANADE DR FL 9
OXNARD CA
93036-1275
US

IV. Provider business mailing address

300 E ESPLANADE DR FL 9
OXNARD CA
93036-1275
US

V. Phone/Fax

Practice location:
  • Phone: 805-302-1358
  • Fax: 805-666-3634
Mailing address:
  • Phone: 805-302-1358
  • Fax: 805-666-3634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT53356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: