Healthcare Provider Details

I. General information

NPI: 1235063454
Provider Name (Legal Business Name): ANDRADE MARRIAGE & FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 RALSTON ST STE 103
VENTURA CA
93003-6042
US

IV. Provider business mailing address

5450 RALSTON ST STE 103
VENTURA CA
93003-6042
US

V. Phone/Fax

Practice location:
  • Phone: 805-539-7191
  • Fax:
Mailing address:
  • Phone: 805-539-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ADA ANDRADE
Title or Position: OWNER/THERAPIST
Credential: LMFT
Phone: 805-539-7191