Healthcare Provider Details

I. General information

NPI: 1184552085
Provider Name (Legal Business Name): KELLI OHARROW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2854
US

IV. Provider business mailing address

1057 BATH LN
VENTURA CA
93001-3816
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-5011
  • Fax:
Mailing address:
  • Phone: 805-948-5078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number774244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: