Provider Demographics
| NPI: | 1821253402 |
|---|---|
| Name: | COUNTY OF VENTURA |
| Entity Type: | Organization |
| Organization Name: | COUNTY OF VENTURA |
| Other - Org Name: | VENTURA COUNTY MEDICAL CENTER |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | CHIEF DEPUTY DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KIM |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MILSTIEN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 805-652-6058 |
| Mailing Address - Street 1: | 800 S VICTORIA AVE # 4615 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | VENTURA |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 93009-0003 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 805-648-9562 |
| Mailing Address - Fax: | 805-648-9561 |
| 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: | 805-652-6000 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-07-23 |
| Last Update Date: | 2019-01-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | 261Q00000X, 261QF0050X, 261QI0500X, 261QM0801X, 261QM0850X, 261QM0855X, 261QM1300X, 261QM2500X, 261QP0905X, 261QP2000X, 261QP2300X, 261QR0200X, 261QR0206X, 261QU0200X, 282N00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 282N00000X | Hospitals | General Acute Care Hospital | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QF0050X | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical |
| No | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | Infusion Therapy |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
| No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
| No | 261QP0905X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, State or Local |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
| No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
| No | 261QR0206X | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mammography |
| No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | LAB58856F | Medicaid | |
| CA | ZZT39008W | Medicaid | |
| CA | ZZT49004F | Medicaid | |
| CA | ZZT39008F | Medicaid | |
| AZ | 025553 | Medicaid | |
| OR | 187047 | Medicaid | |
| WA | 3004405 | Medicaid | |
| CA | GR0072000 | Medicaid | |
| CA | HSC39008W | Medicaid | |
| CA | HSD39008F | Medicaid | |
| CA | GR0072001 | Medicaid | |
| CA | HSC39008F | Medicaid | |
| CA | LAB01063F | Medicaid | |
| CA | ZZT49008F | Medicaid | |
| WA | 3004405 | Medicaid | |
| CA | LAB01063F | Medicaid |
