MEDICARE: ANDRES FERNANDO ROMERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	172V00000X	Community Health Worker	CA
2	373H00000X	Day Training/Habilitation Specialist	CA
3	225400000X	Rehabilitation Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56CC	OTHER	CA	ASPIRA

General Provider Information

NPI Number	:	1265271357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES FERNANDO ROMERO

Provider Business Mailing Address
First Line	:	3601 CALLE TECATE STE 230
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-5056
Country	:	US
Telephone Number	:	805-289-0120
Fax Number	:	805-289-0130

Provider Business Practice Location Address
First Line	:	3601 CALLE TECATE STE 230
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-5056
Country	:	US
Telephone Number	:	805-289-0120
Fax Number	:	805-289-0130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	06/30/2026

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