Healthcare Provider Details

I. General information

NPI: 1346129178
Provider Name (Legal Business Name): DAWN MICHELLE ANDERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W GONZALES RD
OXNARD CA
93036-7768
US

IV. Provider business mailing address

1560 REGENT ST
CAMARILLO CA
93010-4553
US

V. Phone/Fax

Practice location:
  • Phone: 805-278-1853
  • Fax: 805-278-5016
Mailing address:
  • Phone: 805-312-2609
  • Fax: 805-278-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number489587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: