Healthcare Provider Details

I. General information

NPI: 1942770656
Provider Name (Legal Business Name): SHEILA ESTELLE NEIRA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 SYCAMORE DR STE 204-205
SIMI VALLEY CA
93065-1207
US

IV. Provider business mailing address

5081 GALANO DR
CAMARILLO CA
93012-5235
US

V. Phone/Fax

Practice location:
  • Phone: 805-578-9620
  • Fax: 805-955-0498
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95008873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: