Healthcare Provider Details

I. General information

NPI: 1932304391
Provider Name (Legal Business Name): MILDRED ELINORE SCHLIMGEN LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2007
Last Update Date: 05/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1954 LOMA DR
CAMARILLO CA
93010-3719
US

IV. Provider business mailing address

241 MARKET STREET
PORT HUENEME CA
93041
US

V. Phone/Fax

Practice location:
  • Phone: 310-867-0225
  • Fax:
Mailing address:
  • Phone: 805-283-4737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License NumberPT27981
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number560036BP
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number560036AP
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: