Provider Demographics
NPI:1841763703
Name:ANAYA, ERNESTINA ISABELLE
Entity Type:Individual
Prefix:
First Name:ERNESTINA
Middle Name:ISABELLE
Last Name:ANAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 FRESCA DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0163
Mailing Address - Country:US
Mailing Address - Phone:805-816-1728
Mailing Address - Fax:
Practice Address - Street 1:709 FRESCA DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0163
Practice Address - Country:US
Practice Address - Phone:805-816-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst