Healthcare Provider Details

I. General information

NPI: 1316857311
Provider Name (Legal Business Name): JAMIE SCARNECCHIA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1884 EASTMAN AVE STE 103
VENTURA CA
93003-5764
US

IV. Provider business mailing address

1884 EASTMAN AVE STE 103
VENTURA CA
93003-5764
US

V. Phone/Fax

Practice location:
  • Phone: 805-500-5080
  • Fax:
Mailing address:
  • Phone: 805-500-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number95041462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: