Healthcare Provider Details

I. General information

NPI: 1194937102
Provider Name (Legal Business Name): LAURA FARHAT APN-BC FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MARICOPA HWY
OJAI CA
93023-3129
US

IV. Provider business mailing address

1385 S HIGHLAND AVE
JACKSON TN
38301-7525
US

V. Phone/Fax

Practice location:
  • Phone: 805-640-8293
  • Fax:
Mailing address:
  • Phone: 731-427-0470
  • Fax: 731-427-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003881
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 6504
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: