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General NPI Number Information
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NPI Number | 1154125136
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHYSICIANS OF VENTURA COUNTY
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 124 N BRENT ST
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City | VENTURA
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State | CA
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Zip | 93003-2810
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Country | US
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Telephone | 805-948-2825
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Fax | 805-948-2826
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Provider Business Mailing Address
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Address Line | 5855 OLIVAS PARK DR
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City | VENTURA
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State | CA
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Zip | 93003-7672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | RICHARD A REISMAN
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Credential |
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Telephone | 805-643-8695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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