Provider Demographics
NPI:1578238531
Name:SERENITY OAK, LCSW, INC.
Entity type:Organization
Organization Name:SERENITY OAK, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:661-434-1104
Mailing Address - Street 1:1672 W AVENUE J STE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2861
Mailing Address - Country:US
Mailing Address - Phone:323-901-6303
Mailing Address - Fax:
Practice Address - Street 1:1672 W AVENUE J STE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2861
Practice Address - Country:US
Practice Address - Phone:661-434-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health