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Organization
PDAP OF VENTURA COUNTY
Active
Organization
PDAP OF VENTURA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA A WALLACE CATC, CAMF (COUNSELOR)
(805) 482-1265
Entity
Organization
Contact information
Practice address
10738 ENCINO DR, OAK VIEW, CA 93022-9238
(805) 233-4939
Mailing address
10738 ENCINO DR, OAK VIEW, CA 93022-9238
(805) 233-4939
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
040970
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040970
COUNSELOR
CA
Enumeration date
03/29/2007
Last updated
08/22/2020
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