Healthcare Provider Details

I. General information

NPI: 1962600296
Provider Name (Legal Business Name): VEENA S NARAYANAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 FLYNN RD
CAMARILLO CA
93012-8704
US

IV. Provider business mailing address

408 CAMINO DE CELESTE
THOUSAND OAKS CA
91360-7119
US

V. Phone/Fax

Practice location:
  • Phone: 805-388-7740
  • Fax: 805-482-0987
Mailing address:
  • Phone: 805-492-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS12019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: