Healthcare Provider Details
I. General information
NPI: 1457139032
Provider Name (Legal Business Name): BIANCA ANGELICA COBARRUVIAS MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/15/2023
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 S B ST OFC 2
OXNARD CA
93030-5624
US
IV. Provider business mailing address
PO BOX 25
OXNARD CA
93032-0025
US
V. Phone/Fax
- Phone: 805-814-5754
- Fax:
- Phone: 805-814-5754
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 133046 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 11420 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: