MEDICARE: PEAK PREP PLEASANT VALLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1194687855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK PREP PLEASANT VALLEY

Provider Business Mailing Address
First Line	:	2150 PICKWICK DR # 304
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-9998
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 TEMPLE AVE
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-4833
Country	:	US
Telephone Number	:	855-900-7325
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. SHALEN BISHOP
Credential	:
Telephone Number	:	805-222-0025

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “PEAK PREP PLEASANT VALLEY ” Practice Location

Language	Start Address	Practice Location

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