Healthcare Provider Details

I. General information

NPI: 1710188834
Provider Name (Legal Business Name): LOLITA NAANOS FERNANDEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE
VENTURA CA
93003-1651
US

IV. Provider business mailing address

300 HILLMONT AVE
VENTURA CA
93003-1651
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6560
  • Fax: 805-652-6550
Mailing address:
  • Phone: 805-652-6560
  • Fax: 805-652-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN352850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: