Healthcare Provider Details

I. General information

NPI: 1730581430
Provider Name (Legal Business Name): CYNTHIA URENA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 SPRING RD BLDG. A
MOORPARK CA
93021-1298
US

IV. Provider business mailing address

2323 KNOLL DR SUITE 219
VENTURA CA
93003-7307
US

V. Phone/Fax

Practice location:
  • Phone: 805-523-5400
  • Fax: 805-523-2233
Mailing address:
  • Phone: 805-677-5312
  • Fax: 805-523-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95001162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: