Provider Demographics
NPI:1053652057
Name:MISSION OAKS COUNSELING AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:MISSION OAKS COUNSELING AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:WONDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:805-482-7724
Mailing Address - Street 1:1100 FLYNN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8737
Mailing Address - Country:US
Mailing Address - Phone:805-482-7724
Mailing Address - Fax:805-618-6250
Practice Address - Street 1:1100 FLYNN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8737
Practice Address - Country:US
Practice Address - Phone:805-482-7724
Practice Address - Fax:805-618-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 29818106H00000X
CAMFT 49417106H00000X
CA294473163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition SupportGroup - Multi-Specialty