Healthcare Provider Details
I. General information
NPI: 1720401409
Provider Name (Legal Business Name): JOCELYN RAGAMAT DUONG REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 HILLMONT AVE
VENTURA CA
93003-1651
US
IV. Provider business mailing address
2800 ALTUS WAY
OXNARD CA
93035-2507
US
V. Phone/Fax
- Phone: 805-233-7750
- Fax:
- Phone: 408-221-1864
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | 794739 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: