Healthcare Provider Details

I. General information

NPI: 1629959812
Provider Name (Legal Business Name): SIMI VALLEY REGIONAL URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 SYCAMORE DR STE 101
SIMI VALLEY CA
93065-1208
US

IV. Provider business mailing address

2925 SYCAMORE DR STE 101
SIMI VALLEY CA
93065-1208
US

V. Phone/Fax

Practice location:
  • Phone: 805-468-7828
  • Fax: 805-468-7830
Mailing address:
  • Phone: 805-468-7828
  • Fax: 805-468-7830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VINCENT M ESTACIO
Title or Position: PARTNER
Credential: RN
Phone: 661-673-3204