Healthcare Provider Details

I. General information

NPI: 1376190835
Provider Name (Legal Business Name): JULIA REBECCA CARRINGTON LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 S LEWIS RD
CAMARILLO CA
93012-8520
US

IV. Provider business mailing address

4744 TELEPHONE RD STE 3 158
VENTURA CA
93003
US

V. Phone/Fax

Practice location:
  • Phone: 805-702-2930
  • Fax:
Mailing address:
  • Phone: 253-266-9929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number230188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: