Healthcare Provider Details

I. General information

NPI: 1427704733
Provider Name (Legal Business Name): WINDSOR FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 LOMA VISTA RD STE F
VENTURA CA
93003-2965
US

IV. Provider business mailing address

PO BOX 1206
GOLETA CA
93116-1206
US

V. Phone/Fax

Practice location:
  • Phone: 805-875-9150
  • Fax: 805-244-0341
Mailing address:
  • Phone: 805-964-3838
  • Fax: 805-683-3400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NOELLE WINDSOR
Title or Position: AUTHORIZED REPRESENTATIVE/OWNER
Credential: DO
Phone: 895-832-1421