Healthcare Provider Details

I. General information

NPI: 1235840299
Provider Name (Legal Business Name): SEVINA ALTANOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST STE C
OXNARD CA
93033-4573
US

IV. Provider business mailing address

2500 S C ST STE C
OXNARD CA
93033-4573
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-9466
  • Fax:
Mailing address:
  • Phone: 805-385-9466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: