Provider Demographics
NPI:1841305539
Name:JAFFEY, AMY KAREN (PHD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KAREN
Last Name:JAFFEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E ESPLANADE DR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1238
Mailing Address - Country:US
Mailing Address - Phone:805-981-3982
Mailing Address - Fax:805-988-0570
Practice Address - Street 1:300 E ESPLANADE DR
Practice Address - Street 2:SUITE 900
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1238
Practice Address - Country:US
Practice Address - Phone:805-981-3982
Practice Address - Fax:805-988-0570
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13214103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6157290OtherUNITED HEALTHCARE
300401OtherSEAVIEW IPA
073312OtherMANAGED HEALTH
908501OtherPACIFICARE
OPL132140OtherBLUE SHIELD
908501OtherPACIFICARE
OPL132140OtherBLUE SHIELD