Provider Demographics
NPI:1245364215
Name:ROMERO, JESUS JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:
Last Name:ROMERO
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7500
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93031-7500
Mailing Address - Country:US
Mailing Address - Phone:805-415-0519
Mailing Address - Fax:
Practice Address - Street 1:2100 JASMINE ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2321
Practice Address - Country:US
Practice Address - Phone:805-604-9439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS224141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical