Healthcare Provider Details

I. General information

NPI: 1164211579
Provider Name (Legal Business Name): NANCY DAVILA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 S HILL RD
VENTURA CA
93003-4401
US

IV. Provider business mailing address

247 S HILL RD
VENTURA CA
93003-4401
US

V. Phone/Fax

Practice location:
  • Phone: 805-289-1800
  • Fax:
Mailing address:
  • Phone: 805-289-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: