Healthcare Provider Details

I. General information

NPI: 1154470094
Provider Name (Legal Business Name): DEBRA SUE HERRERA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS DEBRA SUE SILVA

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 OUTLET CENTER DR SUITE 220
OXNARD CA
93036-0663
US

IV. Provider business mailing address

PO BOX 201
CAMARILLO CA
93011-0201
US

V. Phone/Fax

Practice location:
  • Phone: 805-388-8830
  • Fax: 805-388-8030
Mailing address:
  • Phone: 805-388-8330
  • Fax: 805-388-8030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: