Provider Demographics
NPI:1710407762
Name:SIDDIQI, BADIA (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:BADIA
Middle Name:
Last Name:SIDDIQI
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:CRYSTAL-JADE
Other - Middle Name:
Other - Last Name:ROBINSON-SIDDIQI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2130 N VENTURA RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2246
Mailing Address - Country:US
Mailing Address - Phone:916-415-8612
Mailing Address - Fax:
Practice Address - Street 1:2130 N VENTURA RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2246
Practice Address - Country:US
Practice Address - Phone:510-317-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119195106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist