Healthcare Provider Details

I. General information

NPI: 1740196609
Provider Name (Legal Business Name): ROYA BANAIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 CALLE ARROYO
THOUSAND OAKS CA
91360-2577
US

IV. Provider business mailing address

633 CALLE ARROYO
THOUSAND OAKS CA
91360-2577
US

V. Phone/Fax

Practice location:
  • Phone: 805-370-4380
  • Fax: 805-370-4460
Mailing address:
  • Phone: 805-370-4380
  • Fax: 805-370-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: