Healthcare Provider Details

I. General information

NPI: 1649674912
Provider Name (Legal Business Name): JAMIE LEONA HUTHSING IMF 70195
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

IV. Provider business mailing address

4700 DEXTER DR APT 8
SANTA BARBARA CA
93110-1325
US

V. Phone/Fax

Practice location:
  • Phone: 866-998-2243
  • Fax:
Mailing address:
  • Phone: 805-450-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number70195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: