Provider Demographics
NPI:1033345723
Name:BELISLE, REX CHARLES II
Entity type:Individual
Prefix:MR
First Name:REX
Middle Name:CHARLES
Last Name:BELISLE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-5910
Mailing Address - Country:US
Mailing Address - Phone:805-988-1112
Mailing Address - Fax:805-988-4883
Practice Address - Street 1:314 W 4TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-5910
Practice Address - Country:US
Practice Address - Phone:805-988-1112
Practice Address - Fax:805-988-4883
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)