Healthcare Provider Details

I. General information

NPI: 1386593994
Provider Name (Legal Business Name): MICHELLE BORAL AMPARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N ROSE AVE
OXNARD CA
93030-3722
US

IV. Provider business mailing address

3010 DUNKIRK DR
OXNARD CA
93035-1261
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2500
  • Fax:
Mailing address:
  • Phone: 805-216-6491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95038394
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number680902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: