Healthcare Provider Details

I. General information

NPI: 1922881150
Provider Name (Legal Business Name): COUNTY OF VENTURA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 MARCH ST
SANTA PAULA CA
93060-2511
US

IV. Provider business mailing address

800 S VICTORIA AVE # L4640
VENTURA CA
93009-0003
US

V. Phone/Fax

Practice location:
  • Phone: 59-338-3838
  • Fax: 805-525-2405
Mailing address:
  • Phone: 805-677-5146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BARRY ZIMMERMAN
Title or Position: DIRECTOR
Credential:
Phone: 805-677-5105