Healthcare Provider Details

I. General information

NPI: 1083291348
Provider Name (Legal Business Name): SOFIA BARTOLONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4482 MARKET ST STE 406
VENTURA CA
93003-7780
US

IV. Provider business mailing address

1014 S WESTLAKE BLVD STE 14-1540
WESTLAKE VILLAGE CA
91361-3108
US

V. Phone/Fax

Practice location:
  • Phone: 805-890-2289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: