Healthcare Provider Details

I. General information

NPI: 1962568246
Provider Name (Legal Business Name): COMPASSION ON CALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31125 VIA COLINAS STE 902
WESTLAKE VILLAGE CA
91362-3969
US

IV. Provider business mailing address

PO BOX 4124
THOUSAND OAKS CA
91359-1124
US

V. Phone/Fax

Practice location:
  • Phone: 818-264-6284
  • Fax:
Mailing address:
  • Phone: 818-264-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number42556
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number443269
License Number StateCA

VIII. Authorized Official

Name: MS. DAMARIS MARTINEZ-WARKENTIEN
Title or Position: DIRECTOR
Credential: RN, MFT
Phone: 818-264-6284