Provider Demographics
NPI:1447863279
Name:JUAREZ, ANISSA SIRENA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ANISSA
Middle Name:SIRENA
Last Name:JUAREZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S C ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4560
Mailing Address - Country:US
Mailing Address - Phone:805-385-9460
Mailing Address - Fax:
Practice Address - Street 1:2500 S C ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4560
Practice Address - Country:US
Practice Address - Phone:805-385-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102625104100000X, 1041C0700X
CA1289751041C0700X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program