Healthcare Provider Details

I. General information

NPI: 1093998817
Provider Name (Legal Business Name): CARIDAD CABANA LVN, LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 E VINEYARD AVE
OXNARD CA
93036-1013
US

IV. Provider business mailing address

4333 E VINEYARD AVE
OXNARD CA
93036-1013
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-5576
  • Fax:
Mailing address:
  • Phone: 805-981-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberPT 21364
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN96522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: