Provider Demographics
NPI:1033260682
Name:TOMIMITSU-CASEY, JENNIFER (BA AND ADS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:TOMIMITSU-CASEY
Suffix:
Gender:F
Credentials:BA AND ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 DUMETZ ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6511
Mailing Address - Country:US
Mailing Address - Phone:805-947-8767
Mailing Address - Fax:
Practice Address - Street 1:2055 SAVIERS RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3608
Practice Address - Country:US
Practice Address - Phone:805-483-2253
Practice Address - Fax:805-483-2255
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAJEN07AEGISMedicare ID - Type UnspecifiedSUBSTANCE USE DISORDER