TARA MODAFF (NPI# 1699958686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699958686 |
| Entity Type | Individual |
| Full Name | TARA MODAFF |
| Credential | M.A., LMFT |
| Practice Address |
5284 Adolfo Rd Camarillo CA 93012-6787 |
| Mailing Address |
Po Box 6003 Ventura CA 93006-6003 |
| Practice Telephone | 8052890120 |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2016-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
5284 ADOLFO RD |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93012-6787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407920663 | Ida Carlson | Counselor | 5284 Adolfo Rd, Suite 100, Camarillo, CA 93012-6787 | 2006-11-20 |
| 1619589694 | Michelle Nichole Avila | Marriage & Family Therapist | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2020-08-20 |
| 1730703067 | Alejandro Rodriguez | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2020-06-02 |
| 1285269183 | Melanie Simms | Marriage & Family Therapist | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2020-03-11 |
| 1669007266 | Osvaldo Perez | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2020-03-04 |
| 1992347819 | Matthew Lopez | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2019-10-11 |
| 1295386969 | Ashley Elizabeth Barrera | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2019-09-24 |
| 1427606078 | Adrienne Aguiar | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2019-08-27 |
| 1316504822 | Jennifer Chavez | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2019-05-21 |
| 1104381177 | Carlos Espitia | Counselor | 5284 Adolfo Rd, Camarillo, CA 93012-6787 | 2019-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322895 | Natasha Nichole Johnson | Licensed Vocational Nurse | 1750 A S Lewis Rs, Camarillo, CA 93012 | 2020-06-26 |
| 1609392604 | Dain Emmanuel Acevedo | Counselor | 5284 Adolfo Road Suite 100, Camarillo, CA 93012 | 2017-08-21 |
| 1679093751 | Emily Sophia Rodriguez | Counselor | 5284 Adolfo Rd. Suite 100, Camarillo, CA 93012 | 2017-06-21 |
| 1164952750 | Valerie Marie Inez Rivera | Counselor | 5284 Adolfo Rd #100, Camarillo, CA 93012 | 2017-06-15 |
| 1457890709 | Constance Walsh | Prosthetic/Orthotic Supplier | 795 Camarillo Springs Rd, Suite C, Carmarillo, CA 93012 | 2017-02-20 |
| 1902349020 | Ferdinand Fortune Cuico | Registered Nurse | 421 Brister Park Ct, Camarillo, CA 93012 | 2016-11-21 |
| 1699226795 | Lauren Streiter | Counselor | 1750b S Lewis Rd, Camarillo, CA 93012 | 2016-10-24 |
| 1972955649 | Evolve Growth Initiatives, LLC | Community Based Residential Treatment Facility, Mental Illness | 799 Camarillo Springs Road, Ventura, CA 93012 | 2016-07-06 |
| 1083075089 | Justin Rodriguez Urbano | Dental Hygienist | 4422 Corte Arbusto, Camarillo, CA 93012 | 2016-03-18 |
| 1578924619 | Leslie Winn | Counselor | 291 Camino Leon, Camarillo, CA 93012 | 2016-03-17 |
| Find all providers in zip 93012 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239394 | Desiree Butler | Counselor | 975 Flynn Rd # 8704, Camarillo, CA 93012-8704 | 2020-09-14 |
| 1023573284 | Anthony Omar Thompson | Counselor | 954 Gracia St, Camarillo, CA 93010-3940 | 2019-02-01 |
| 1073081741 | Tyler Briann Aliano-kirksey | Counselor | 2009 Las Estrellas Ct, Camarillo, CA 93012-4070 | 2018-11-11 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1750860730 | Gina P. Martinez | Counselor | 5284 Adolfo Rd # Sweet100, Camarillo, CA 93012-6787 | 2018-08-09 |
| 1942794326 | Raymundo Cervantes | Counselor | 153 Ripley St, Camarillo, CA 93010-2617 | 2018-06-19 |
| 1609392604 | Dain Emmanuel Acevedo | Counselor | 5284 Adolfo Road Suite 100, Camarillo, CA 93012 | 2017-08-21 |
| 1679093751 | Emily Sophia Rodriguez | Counselor | 5284 Adolfo Rd. Suite 100, Camarillo, CA 93012 | 2017-06-21 |
| 1164952750 | Valerie Marie Inez Rivera | Counselor | 5284 Adolfo Rd #100, Camarillo, CA 93012 | 2017-06-15 |
| 1326574211 | Sintya Liseth Herrera Rodriguez | Counselor | 5284 Adolfo Rd Ste 200, Camarillo, CA 93012-6788 | 2017-05-11 |
| Find all providers in CAMARILLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.