Basic Information
| Provider Information | |||||||||
| NPI: | 1295498285 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABANBAN | ||||||||
| FirstName: | MARIA-BLESSILDA | ||||||||
| MiddleName: | VILLARIN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 S C ST STE C | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930334573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053859420 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2500 S C ST STE C | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930334573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053859420 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2021 | ||||||||
| LastUpdateDate: | 10/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 125425 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.