Provider Demographics
NPI:1669776019
Name:OXENBERG, MARI CHRISTINA (CNM)
Entity type:Individual
Prefix:MS
First Name:MARI
Middle Name:CHRISTINA
Last Name:OXENBERG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3107
Mailing Address - Country:US
Mailing Address - Phone:310-455-9020
Mailing Address - Fax:
Practice Address - Street 1:712 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:TOPANGA
Practice Address - State:CA
Practice Address - Zip Code:90290-3107
Practice Address - Country:US
Practice Address - Phone:310-455-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1934176B00000X
CA681309163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife