Provider Demographics
NPI:1235349499
Name:BORGESON, JAMES KELLER (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KELLER
Last Name:BORGESON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 E THOMPSON BLVD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-2918
Mailing Address - Country:US
Mailing Address - Phone:805-643-1446
Mailing Address - Fax:805-643-0271
Practice Address - Street 1:856 E THOMPSON BLVD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2918
Practice Address - Country:US
Practice Address - Phone:805-643-1446
Practice Address - Fax:805-643-0271
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34204106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist