Provider Demographics
NPI:1972392884
Name:JUAREZ, PAULINA (PPS 220144005)
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:
Credentials:PPS 220144005
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N MARQUITA ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3792
Mailing Address - Country:US
Mailing Address - Phone:805-385-1524
Mailing Address - Fax:
Practice Address - Street 1:301 N MARQUITA ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3792
Practice Address - Country:US
Practice Address - Phone:805-385-1524
Practice Address - Fax:805-385-1524
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220144005101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor