Healthcare Provider Details

I. General information

NPI: 1497209506
Provider Name (Legal Business Name): DESTINY ZAMARRIPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HILLMONT AVE
VENTURA CA
93003-1651
US

IV. Provider business mailing address

350 HILLMONT AVE
VENTURA CA
93003-1651
US

V. Phone/Fax

Practice location:
  • Phone: 805-233-7750
  • Fax:
Mailing address:
  • Phone: 805-233-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number941735271
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: