Provider Demographics
NPI:1679905830
Name:HIPPLE, WENDY (MA)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:HIPPLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1911 WILLIAMS DR STE 165
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-981-4233
Mailing Address - Fax:805-981-9268
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-4233
Practice Address - Fax:805-981-9268
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT105344106H00000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist