Provider Demographics
NPI:1235598459
Name:AMEZQUITA, WENDI (LCSW)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:
Last Name:AMEZQUITA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:CHRISTINE
Other - Last Name:AMEZQUITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:909-908-6880
Mailing Address - Fax:
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:SUITE E
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:909-908-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA680461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical