Healthcare Provider Details

I. General information

NPI: 1255819439
Provider Name (Legal Business Name): HULL VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 ERTEN ST
THOUSAND OAKS CA
91360-1809
US

IV. Provider business mailing address

128 ERTEN ST
THOUSAND OAKS CA
91360-1809
US

V. Phone/Fax

Practice location:
  • Phone: 805-777-3855
  • Fax: 805-777-3844
Mailing address:
  • Phone: 805-777-3855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number564700003
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number564700003
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number564700003
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number564700003
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number564700003
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number564700003
License Number StateCA

VIII. Authorized Official

Name: DYLAN HULL
Title or Position: CEO/ ADMINISTRATOR
Credential:
Phone: 805-777-3855