Healthcare Provider Details

I. General information

NPI: 1750529152
Provider Name (Legal Business Name): MR. JOSE CUERVO SOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5643
OXNARD CA
93031-5643
US

IV. Provider business mailing address

PO BOX 5643
OXNARD CA
93031-5643
US

V. Phone/Fax

Practice location:
  • Phone: 805-396-3859
  • Fax:
Mailing address:
  • Phone: 805-396-3859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150958
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: