Healthcare Provider Details

I. General information

NPI: 1891206264
Provider Name (Legal Business Name): VENTURA COUNTY COMMUNITY COLLEGE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 S ROSE AVE
OXNARD CA
93033-6699
US

IV. Provider business mailing address

4000 SOUTH ROSE AVENUE STUDENT HEALTH CENTER
OXNARD CA
93033-6699
US

V. Phone/Fax

Practice location:
  • Phone: 805-678-5832
  • Fax: 805-678-5932
Mailing address:
  • Phone: 805-678-5832
  • Fax: 805-678-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEANNA MCFADDEN
Title or Position: DIRECTOR, STUDENT HEALTH CENTER
Credential: NP
Phone: 805-678-5832