Provider Demographics
NPI:1053580720
Name:POWERS, EILEEN P (MFT INTERN)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:P
Last Name:POWERS
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 N A ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-4310
Mailing Address - Country:US
Mailing Address - Phone:805-983-3636
Mailing Address - Fax:805-988-2240
Practice Address - Street 1:829 N A ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-4310
Practice Address - Country:US
Practice Address - Phone:805-983-3636
Practice Address - Fax:805-988-2240
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist