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General NPI Number Information
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NPI Number | 1811367436
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 2200 E GONZALES RD
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City | OXNARD
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State | CA
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Zip | 93036-0619
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Country | US
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Telephone | 805-604-6025
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Fax | 805-604-6039
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Provider Business Mailing Address
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Address Line | PO BOX 4084
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-4084
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Country | US
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Telephone | 805-604-6025
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Fax | 805-604-6039
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Authorized Official
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Title or Position | MEDICAL SOCIAL WORKER
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Name | MS. OLGA VANESS ORTIZ
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Credential | LCSW
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Telephone | 805-604-6025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | LCSW68432
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License Number State | CA
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