Healthcare Provider Details

I. General information

NPI: 1316339930
Provider Name (Legal Business Name): SUZARIE VAN SPENCE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZARIE JOHN-BAPTISTE

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STATHAM BLVD
OXNARD CA
93033
US

IV. Provider business mailing address

1040 FLYNN RD
CAMARILLO CA
93012-5092
US

V. Phone/Fax

Practice location:
  • Phone: 805-330-8685
  • Fax: 805-367-5250
Mailing address:
  • Phone: 805-673-3930
  • Fax: 805-659-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: