Healthcare Provider Details

I. General information

NPI: 1184492100
Provider Name (Legal Business Name): VIRGINIA I CAMPOS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E STOWELL RD STE C
SANTA MARIA CA
93454-7010
US

IV. Provider business mailing address

1130 EAST CLARK AVE SUITE 150- 114
ORCUTT CA
93455-5178
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-5140
  • Fax:
Mailing address:
  • Phone: 805-934-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: