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General NPI Number Information
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NPI Number | 1457481822
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Entity Type | Organization
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Legal Business Name | CONEJO VALLEY WOMEN'S RESOURCE CENTER
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 80 E HILLCREST DR # 130
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4218
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Country | US
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Telephone | 805-373-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 80 E HILLCREST DR # 130
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4218
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Country | US
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Telephone | 805-373-1222
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Fax |
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Authorized Official
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Title or Position | CENTER DIRECTOR
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Name | MRS. PAMELA R BORG
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Credential | RN
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Telephone | 805-373-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State | CA
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