Healthcare Provider Details

I. General information

NPI: 1053227462
Provider Name (Legal Business Name): JILA GISELL VILCHEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 OLDS RD
OXNARD CA
93033-8060
US

IV. Provider business mailing address

1116 SADDLEBACK CIR
CAMARILLO CA
93012-4414
US

V. Phone/Fax

Practice location:
  • Phone: 805-488-4441
  • Fax:
Mailing address:
  • Phone: 818-455-7322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: