Provider Demographics
NPI:1487355228
Name:PONCE, VICTORIA INES
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:INES
Last Name:PONCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 PASEO LINDO
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7372
Mailing Address - Country:US
Mailing Address - Phone:661-903-4494
Mailing Address - Fax:
Practice Address - Street 1:617 PASEO LINDO
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7372
Practice Address - Country:US
Practice Address - Phone:661-903-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst