COUNTY OF VENTURA

NPI # 

Practice Address:

300 Hillmont Ave Ste 302

Ventura, CA, 93003-1651

Practice Phone:

805-652-6255

Practice Fax:

805-641-4494

License Number:

H80CS00247-06-03

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X