Provider Demographics
NPI:1376774810
Name:SARATOGA CLINIC
Entity Type:Organization
Organization Name:SARATOGA CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:VANDUINWYK
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED OCCUPATIONA
Authorized Official - Phone:805-642-8490
Mailing Address - Street 1:1891 GOODYEAR AVENUE
Mailing Address - Street 2:SUITE 605
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-8003
Mailing Address - Country:US
Mailing Address - Phone:805-642-8490
Mailing Address - Fax:805-659-9955
Practice Address - Street 1:1891 GOODYEAR AVENUE
Practice Address - Street 2:SUITE 605
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8003
Practice Address - Country:US
Practice Address - Phone:805-642-8490
Practice Address - Fax:805-659-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty