Healthcare Provider Details

I. General information

NPI: 1508262213
Provider Name (Legal Business Name): INFUSION4HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 ROLLING OAKS DR STE 201
THOUSAND OAKS CA
91361-1018
US

IV. Provider business mailing address

135 S STATE COLLEGE BLVD STE 350
BREA CA
92821-5814
US

V. Phone/Fax

Practice location:
  • Phone: 805-719-3700
  • Fax: 805-413-9099
Mailing address:
  • Phone: 805-719-3700
  • Fax: 805-413-9099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA NAVARRO
Title or Position: CREDENTIALING & CONTRACTS ADMIN
Credential:
Phone: 714-310-3133