Healthcare Provider Details

I. General information

NPI: 1679662035
Provider Name (Legal Business Name): BARBARA YOST ELICES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 ARNEILL RD SUITE B
CAMARILLO CA
93010-6439
US

IV. Provider business mailing address

5855 OLIVAS PARK DR
VENTURA CA
93003-7672
US

V. Phone/Fax

Practice location:
  • Phone: 805-383-4510
  • Fax: 805-383-4511
Mailing address:
  • Phone: 805-667-2801
  • Fax: 805-641-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number299098
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6198
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: