Healthcare Provider Details

I. General information

NPI: 1548006810
Provider Name (Legal Business Name): DR. MICHAEL JUAREZ & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W 5TH ST STE 201
OXNARD CA
93030-7025
US

IV. Provider business mailing address

520 W 5TH ST STE 201
OXNARD CA
93030-7025
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-1112
  • Fax:
Mailing address:
  • Phone: 805-988-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MICHAEL DAVID JUAREZ
Title or Position: PRESIDENT/CEO
Credential: PSY.D.
Phone: 805-988-1112