Healthcare Provider Details

I. General information

NPI: 1801129846
Provider Name (Legal Business Name): OSWALDO RENE NAVARRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 W 3RD ST
PERRIS CA
92570-2071
US

IV. Provider business mailing address

449 W 3RD ST
PERRIS CA
92570-2071
US

V. Phone/Fax

Practice location:
  • Phone: 951-345-9074
  • Fax:
Mailing address:
  • Phone: 951-345-9074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: