Provider Demographics
NPI:1831373646
Name:ZENDEJAS, ELIA (MFCC)
Entity type:Individual
Prefix:MS
First Name:ELIA
Middle Name:
Last Name:ZENDEJAS
Suffix:
Gender:F
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 VENTURA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6697
Mailing Address - Country:US
Mailing Address - Phone:805-322-4875
Mailing Address - Fax:805-204-2440
Practice Address - Street 1:2435 VENTURA BLVD STE A
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6697
Practice Address - Country:US
Practice Address - Phone:805-322-4875
Practice Address - Fax:805-204-2440
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 55004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist