Healthcare Provider Details

I. General information

NPI: 1265368476
Provider Name (Legal Business Name): ZINNIA RAE BUSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5605 COLTRANE ST
VENTURA CA
93003-0224
US

IV. Provider business mailing address

1304 E MAIN ST # 100
VENTURA CA
93001-3202
US

V. Phone/Fax

Practice location:
  • Phone: 805-941-3656
  • Fax:
Mailing address:
  • Phone: 805-941-3656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberA81133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: