Healthcare Provider Details

I. General information

NPI: 1427934736
Provider Name (Legal Business Name): GEORGE GALVAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 RALSTON ST STE 100
VENTURA CA
93003-7847
US

IV. Provider business mailing address

5740 RALSTON ST STE 100
VENTURA CA
93003-7847
US

V. Phone/Fax

Practice location:
  • Phone: 805-289-3100
  • Fax:
Mailing address:
  • Phone: 805-289-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164468
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberY4730854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: