=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659528313
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAULA J AVILA RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2008
-----------------------------------------------------
Last Update Date | 08/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1911 WILLIAMS DR SUITE 165
-----------------------------------------------------
City | OXNARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93036-2612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-981-5400
-----------------------------------------------------
Fax | 805-981-5450
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1911 WILLIAMS DR SUITE 165
-----------------------------------------------------
City | OXNARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93036-2612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-981-5400
-----------------------------------------------------
Fax | 805-981-5450
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0809X
-----------------------------------------------------
Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | 732676
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------