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General NPI Number Information
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NPI Number | 1346756178
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Entity Type | Organization
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Legal Business Name | ALFREDO BIMBELA
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 3585 MAPLE ST STE 233
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City | VENTURA
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State | CA
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Zip | 93003-9148
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Country | US
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Telephone | 805-284-1783
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Fax | 888-958-5269
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Provider Business Mailing Address
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Address Line | 1500 PALMA DR FL 2
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City | VENTURA
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State | CA
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Zip | 93003-6451
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Country | US
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Telephone | 805-284-1783
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Fax | 888-958-5269
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. ALFREDO BIMBELA
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Credential | PHD, FNP, PHMHNP
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Telephone | 805-284-1783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 15951
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License Number State | CA
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