Provider Demographics
NPI:1578917514
Name:COUNTY OF VENTURA AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:COUNTY OF VENTURA AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-477-7300
Mailing Address - Street 1:646 COUNTY SQUARE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-0437
Mailing Address - Country:US
Mailing Address - Phone:805-477-7300
Mailing Address - Fax:805-477-7312
Practice Address - Street 1:646 COUNTY SQUARE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-0437
Practice Address - Country:US
Practice Address - Phone:805-477-7300
Practice Address - Fax:805-477-7312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF VENTURA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMCSUBBK1Medicaid