Healthcare Provider Details

I. General information

NPI: 1962313254
Provider Name (Legal Business Name): COUNTY OF VENTURA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE STE 201
VENTURA CA
93003-1651
US

IV. Provider business mailing address

800 S VICTORIA AVE # L4640
VENTURA CA
93009-0002
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6100
  • Fax: 805-652-3252
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JOHN FANKHAUSER
Title or Position: HCA DIRECTOR
Credential: MD
Phone: 805-652-6058