| Tierra Luz Community Practice, License Clinical Social Worker, A Profe | |
|
721 S A St Ste C Oxnard CA 93030-7179 | |
| (805) 767-9788 | |
| Not Available |
| Full Name | Tierra Luz Community Practice, License Clinical Social Worker, A Profe |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 721 S A St Ste C, Oxnard, California |
| Authorized Official Name and Position | Kathleen Judith Baca Leanos (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6615102423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tierra Luz Community Practice, License Clinical Social Worker, A Profe Po Box 93 Oxnard CA 93032-0093 Ph: (805) 767-9788 | Tierra Luz Community Practice, License Clinical Social Worker, A Profe 721 S A St Ste C Oxnard CA 93030-7179 Ph: (805) 767-9788 |
| NPI Number | 1972478170 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 10/07/2025 |
| Certification Date | 10/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972478170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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