Individual
IVORY MAE CHAVEZ LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 NELSON PL, OXNARD, CA 93033-6613
(805) 824-1887
Mailing address
1540 NELSON PL, OXNARD, CA 93033-6613
(805) 824-1887
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
77840
CA
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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