Healthcare Provider Details

I. General information

NPI: 1023724036
Provider Name (Legal Business Name): KAREN LATHERS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4009 MISSION OAKS BLVD
CAMARILLO CA
93012-5156
US

IV. Provider business mailing address

4009 MISSION OAKS BLVD
CAMARILLO CA
93012-5156
US

V. Phone/Fax

Practice location:
  • Phone: 805-312-9412
  • Fax: 844-407-0518
Mailing address:
  • Phone: 805-312-9412
  • Fax: 844-407-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95023836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: