Healthcare Provider Details

I. General information

NPI: 1629244785
Provider Name (Legal Business Name): LINDA M ALDOUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HILLMONT AVE
VENTURA CA
93003-1647
US

IV. Provider business mailing address

200 HILLMONT AVE
VENTURA CA
93003-1647
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-5755
  • Fax:
Mailing address:
  • Phone: 805-652-5755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number376679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: