Provider Demographics
NPI:1477694107
Name:SHARE OXFORD FOUNDATION
Entity Type:Organization
Organization Name:SHARE OXFORD FOUNDATION
Other - Org Name:SHARE UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANTONIOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-413-1318
Mailing Address - Street 1:3717 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 266
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3607
Mailing Address - Country:US
Mailing Address - Phone:805-413-1318
Mailing Address - Fax:805-413-1304
Practice Address - Street 1:1628 N OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-1514
Practice Address - Country:US
Practice Address - Phone:800-798-6606
Practice Address - Fax:626-791-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190256AN261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder