Organization
SIMI OAKS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST WILSON FEDERER III PHD (OWNER ADMINISTRATOR)
(805) 581-4357
Entity
Organization
Contact information
Practice address
2345 ERRINGER RD, SUITE 106, SIMI VALLEY, CA 93065-2235
(805) 581-4357
(805) 581-6917
Mailing address
67 COZUMEL PL, SIMI VALLEY, CA 93065-4039
(805) 581-4357
(805) 581-6917
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
PSB 30655
CA
Other
Enumeration date
03/29/2007
Last updated
10/29/2012
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