Healthcare Provider Details

I. General information

NPI: 1558054304
Provider Name (Legal Business Name): COUNTY OF VENTURA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E MAIN ST FL 3
SANTA PAULA CA
93060-2748
US

IV. Provider business mailing address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

V. Phone/Fax

Practice location:
  • Phone: 805-933-8440
  • Fax: 805-933-0057
Mailing address:
  • Phone: 805-981-5478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN LEE
Title or Position: QUALITY CARE MANAGEMENT
Credential:
Phone: 805-981-6830