Healthcare Provider Details

I. General information

NPI: 1164878211
Provider Name (Legal Business Name): NICOLE CALVENTO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2016
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 DONLON ST STE 17
VENTURA CA
93003-5638
US

IV. Provider business mailing address

1363 DONLON ST STE 17
VENTURA CA
93003-5638
US

V. Phone/Fax

Practice location:
  • Phone: 747-344-4802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110653
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: