MEDICARE: COUNTY OF VENTURA

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
1	261QF0400X	Federally Qualified Health Center (FQHC)	H80CS00247-06-03	CA

General Provider Information

NPI Number	:	1932340890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF VENTURA

Provider Business Mailing Address
First Line	:	800 S VICTORIA AVE # L4615
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93009-0003
Country	:	US
Telephone Number	:	805-677-5210
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 E MAIN ST
Second Line	:
City	:	SANTA PAULA
State	:	CA
Zip	:	93060-2926
Country	:	US
Telephone Number	:	805-933-1122
Fax Number	:	805-933-0522

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BARRY ZIMMERMAN
Credential	:
Telephone Number	:	805-677-5272

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	06/13/2024

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