Healthcare Provider Details

I. General information

NPI: 1306634316
Provider Name (Legal Business Name): LISA WOFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 JAZMIN AVE
VENTURA CA
93004-1826
US

IV. Provider business mailing address

255 W STANLEY AVE STE 100
VENTURA CA
93001-1331
US

V. Phone/Fax

Practice location:
  • Phone: 805-672-2701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: