Healthcare Provider Details

I. General information

NPI: 1033861703
Provider Name (Legal Business Name): DANIELA CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

IV. Provider business mailing address

1900 BROOKSIDE AVE
OXNARD CA
93035-3321
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-9200
  • Fax:
Mailing address:
  • Phone: 805-366-9915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: