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General NPI Number Information
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NPI Number | 1841299286
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Entity Type | Organization
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Legal Business Name | SIMI VALLEY THERAPIES WEST, INC.
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 4080 LOMA VISTA RD
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City | VENTURA
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State | CA
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Zip | 93003
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Country | US
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Telephone | 805-535-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1390 SORREL ST
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City | SIMI VALLEY
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State | CA
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Zip | 93065-3357
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Country | US
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Telephone | 805-207-6808
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Fax | 805-522-1009
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBORAH ILENE ELMORE-DION
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Credential |
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Telephone | 805-207-6808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT21563
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 21563
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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