Provider Demographics
NPI:1538361274
Name:PASTOR, DEBBIE (CAS, SUDCC, MRAS)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:PASTOR
Suffix:
Gender:F
Credentials:CAS, SUDCC, MRAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-3621
Mailing Address - Country:US
Mailing Address - Phone:805-305-0068
Mailing Address - Fax:
Practice Address - Street 1:4587 TELEPHONE RD STE 210
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8774
Practice Address - Country:US
Practice Address - Phone:805-305-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40-001-03-120101YA0400X
CA400003BN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)