Healthcare Provider Details

I. General information

NPI: 1750404208
Provider Name (Legal Business Name): LENIER SEAN BAXTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SKYWAY DR
CAMARILLO CA
93010-8552
US

IV. Provider business mailing address

333 SKYWAY DR
CAMARILLO CA
93010-8552
US

V. Phone/Fax

Practice location:
  • Phone: 805-383-1155
  • Fax: 805-383-1134
Mailing address:
  • Phone: 805-383-1155
  • Fax: 805-383-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: