Provider Demographics
NPI:1093093536
Name:ANKA VENTURA CRT
Entity Type:Organization
Organization Name:ANKA VENTURA CRT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH REHABILITATION WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-889-7284
Mailing Address - Street 1:3610 SAN SIMEON AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033
Mailing Address - Country:US
Mailing Address - Phone:805-889-7284
Mailing Address - Fax:
Practice Address - Street 1:300 HILLMONT AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1651
Practice Address - Country:US
Practice Address - Phone:818-645-3337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness