Provider Demographics
NPI:1346889201
Name:SKOLNICK, GITI (RN)
Entity Type:Individual
Prefix:
First Name:GITI
Middle Name:
Last Name:SKOLNICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 COUNTY SQUARE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-9086
Mailing Address - Country:US
Mailing Address - Phone:805-477-7300
Mailing Address - Fax:
Practice Address - Street 1:646 COUNTY SQUARE DR STE 100
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-9086
Practice Address - Country:US
Practice Address - Phone:805-477-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95197802171M00000X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult