Provider Demographics
NPI:1457718850
Name:SEGOVIA, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:SEGOVIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 E GONZALES RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-8210
Mailing Address - Country:US
Mailing Address - Phone:805-654-3230
Mailing Address - Fax:
Practice Address - Street 1:4651 TELEPHONE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93033
Practice Address - Country:US
Practice Address - Phone:805-654-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker