Healthcare Provider Details

I. General information

NPI: 1497969422
Provider Name (Legal Business Name): DEANNA MCFADDEN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 S ROSE AVE
OXNARD CA
93033-6683
US

IV. Provider business mailing address

11065 FOOTHILL RD
SANTA PAULA CA
93060-9742
US

V. Phone/Fax

Practice location:
  • Phone: 805-678-5832
  • Fax:
Mailing address:
  • Phone: 805-647-6612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF8558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: