Provider Demographics
NPI:1154528677
Name:LOSTAUNAU, ADRIENNE G (LCSW)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:G
Last Name:LOSTAUNAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-4135
Mailing Address - Country:US
Mailing Address - Phone:805-815-3143
Mailing Address - Fax:
Practice Address - Street 1:1300 W GONZALES RD
Practice Address - Street 2:SUITE 102 A
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-3303
Practice Address - Country:US
Practice Address - Phone:805-604-4430
Practice Address - Fax:805-604-4436
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS69001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical