Provider Demographics
NPI:1053851584
Name:CHILDREN'S CLINIC OF VENTURA COUNTY
Entity Type:Organization
Organization Name:CHILDREN'S CLINIC OF VENTURA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-660-0700
Mailing Address - Street 1:2200 OUTLET CENTER DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 OUTLET CENTER DR
Practice Address - Street 2:SUITE 430
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0611
Practice Address - Country:US
Practice Address - Phone:805-660-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization