Provider Demographics
NPI:1134389224
Name:CISNEROS, ENEDINA (MSW)
Entity type:Individual
Prefix:
First Name:ENEDINA
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 SAVIERS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4593
Mailing Address - Country:US
Mailing Address - Phone:805-486-2929
Mailing Address - Fax:
Practice Address - Street 1:2679 SAVIERS RD STE 230
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4593
Practice Address - Country:US
Practice Address - Phone:805-486-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2019-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker