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General NPI Number Information
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NPI Number | 1487482311
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Entity Type | Individual
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Provider Name | GRACE VICTORIA MILLS
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Gender | Female
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1736 SOUTH LEWIS RD
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City | CAMARILLO
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State | CA
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Zip | 93021
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Country | US
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Telephone | 805-586-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 4054 BRINDISI PL
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City | MOORPARK
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State | CA
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Zip | 93021-3763
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Country | US
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Telephone | 818-585-1165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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