Healthcare Provider Details

I. General information

NPI: 1831532688
Provider Name (Legal Business Name): TRIPOD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 N BRENT ST STE 201
VENTURA CA
93003-2818
US

IV. Provider business mailing address

148 N BRENT ST STE 201
VENTURA CA
93003-2818
US

V. Phone/Fax

Practice location:
  • Phone: 805-585-2273
  • Fax: 805-585-2293
Mailing address:
  • Phone: 805-585-2273
  • Fax: 805-585-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3-13-6808
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: ARCHIE B WILLIAMS
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: RN BSN
Phone: 805-585-2273