Healthcare Provider Details

I. General information

NPI: 1366748907
Provider Name (Legal Business Name): CYNTHIA GLORIA SAENZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2011
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

864 E SANTA CLARA ST
VENTURA CA
93001-2939
US

IV. Provider business mailing address

864 E SANTA CLARA ST
VENTURA CA
93001-2939
US

V. Phone/Fax

Practice location:
  • Phone: 805-643-1446
  • Fax:
Mailing address:
  • Phone: 805-504-5578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW23777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: