Healthcare Provider Details

I. General information

NPI: 1306576707
Provider Name (Legal Business Name): KRISTEL DELACRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N VENTURA RD
OXNARD CA
93030-4413
US

IV. Provider business mailing address

540 GARONNE ST
OXNARD CA
93036-5314
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-1097
  • Fax: 805-983-7402
Mailing address:
  • Phone: 805-980-8358
  • Fax: 805-983-7402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number87924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: