Provider Demographics
NPI:1154836542
Name:CANADA-ZARAGOZA, NESTOR AARON
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:AARON
Last Name:CANADA-ZARAGOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NESTOR
Other - Middle Name:AARON
Other - Last Name:ZARAGOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0673
Mailing Address - Country:US
Mailing Address - Phone:805-289-0120
Mailing Address - Fax:805-981-9250
Practice Address - Street 1:1911 WILLIAMS DRIVE SUITE 200
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036
Practice Address - Country:US
Practice Address - Phone:805-981-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2021-10-26
Deactivation Date:2021-08-30
Deactivation Code:
Reactivation Date:2021-09-30
Provider Licenses
StateLicense IDTaxonomies
CA103136104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56CCOtherASPIRA