Healthcare Provider Details

I. General information

NPI: 1588393508
Provider Name (Legal Business Name): JORDAN KUZMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5810 RALSTON ST
VENTURA CA
93003-5908
US

IV. Provider business mailing address

5810 RALSTON ST
VENTURA CA
93003-5908
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-7033
  • Fax:
Mailing address:
  • Phone: 805-642-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: