1306725478 NPI number — ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION

Table of content: DR. RUBEN LUGO ZAMBRANA MD (NPI 1225023567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306725478 NPI number — ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1306725478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 TOWN CENTER DR STE 300
Provider Second Line Business Mailing Address:
#1060
Provider Business Mailing Address City Name:
OXNARD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93036-1117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-666-1022
Provider Business Mailing Address Fax Number:
805-254-0441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2901 PENINSULA RD APT 131
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93035-4042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-666-1022
Provider Business Practice Location Address Fax Number:
805-254-0441
Provider Enumeration Date:
09/01/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MEADOR
Authorized Official First Name:
JUSTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
805-666-1022

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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