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General NPI Number Information
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NPI Number | 1194687855
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Entity Type | Organization
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Legal Business Name | PEAK PREP PLEASANT VALLEY
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 550 TEMPLE AVE
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City | CAMARILLO
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State | CA
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Zip | 93010-4833
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Country | US
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Telephone | 855-900-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 PICKWICK DR # 304
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City | CAMARILLO
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State | CA
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Zip | 93010-9998
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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 | EXECUTIVE DIRECTOR
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Name | DR. SHALEN BISHOP
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Credential |
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Telephone | 805-222-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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