Healthcare Provider Details

I. General information

NPI: 1619269206
Provider Name (Legal Business Name): MONICA LORRIANE DURAN RN, CNOR, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2011
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 TULL ST
VENTURA CA
93003-9095
US

IV. Provider business mailing address

5618 TULL ST
VENTURA CA
93003-9095
US

V. Phone/Fax

Practice location:
  • Phone: 805-658-2071
  • Fax: 805-658-8626
Mailing address:
  • Phone: 805-658-2071
  • Fax: 805-658-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number572843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: