Healthcare Provider Details

I. General information

NPI: 1558227256
Provider Name (Legal Business Name): JAVIER JESUS CANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2025
Last Update Date: 12/27/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST STE D
OXNARD CA
93033-4574
US

IV. Provider business mailing address

2500 S C ST STE D
OXNARD CA
93033-4574
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-9460
  • Fax:
Mailing address:
  • Phone: 805-385-9460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT159979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: