MEDICARE: ALLISON HAN

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	363L00000X	Nurse Practitioner	NP95037480	CA

General Provider Information

NPI Number	:	1386513075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON HAN

Provider Business Mailing Address
First Line	:	147 W JANSS RD
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-3343
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2438 N PONDEROSA DR STE 101
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-2465
Country	:	US
Telephone Number	:	805-383-9727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2025
Last Update Date	:	03/29/2026

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Directions to “ ALLISON HAN ” Practice Location

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