Provider Demographics
NPI:1699961052
Name:BLUESKYES, OCEANA MIRACLE (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:OCEANA
Middle Name:MIRACLE
Last Name:BLUESKYES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE STE 708
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6842
Mailing Address - Country:US
Mailing Address - Phone:888-851-5595
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 708
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232
Practice Address - Country:US
Practice Address - Phone:888-851-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51105106H00000X
CAIMF57187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist