Healthcare Provider Details

I. General information

NPI: 1528962768
Provider Name (Legal Business Name): ULRIKE NAGORSEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PASEO CAMARILLO STE 245
CAMARILLO CA
93010-6085
US

IV. Provider business mailing address

1200 PASEO CAMARILLO STE 245
CAMARILLO CA
93010-6085
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-6197
  • Fax:
Mailing address:
  • Phone: 805-988-6197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number36989
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: