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NPI Code Detail

MEDICARE: GENESIS PROGRAMS, INC.

MEDICARE: GENESIS PROGRAMS, INC.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency560032BPCA

General Provider Information

NPI Number : 1568681229
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS PROGRAMS, INC.
Provider Business Mailing Address
First Line : 1732 PALMA DR.
Second Line : SUITE 208
City : VENTURA
State : CA
Zip : 93003-5796
Country : US
Telephone Number : 805-650-3094
Fax Number : 805-650-3094
Provider Business Practice Location Address
First Line : 145 HODENCAMP RD
Second Line : SUITE 207
City : THOUSAND OAKS
State : CA
Zip : 91360-5810
Country : US
Telephone Number : 805-497-6169
Fax Number : 805-497-6179
Authorized Official
Title or Position : CEO/CLINICAL DIRECTOR
Name : MRS. ATHENA NARANJO
Credential : LAADC
Telephone Number : 805-650-3094
Provider Enumeration Date : 04/24/2007
Last Update Date : 11/28/2018

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Directions to “GENESIS PROGRAMS, INC. ” Practice Location

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