Healthcare Provider Details

I. General information

NPI: 1063532620
Provider Name (Legal Business Name): RHONDA FLEISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 RALSTON ST STE 200
VENTURA CA
93003-6009
US

IV. Provider business mailing address

5740 RALSTON ST STE 200
VENTURA CA
93003-6009
US

V. Phone/Fax

Practice location:
  • Phone: 805-289-3198
  • Fax: 805-289-3201
Mailing address:
  • Phone: 805-289-3198
  • Fax: 805-289-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License NumberPT24401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: