Provider Demographics
NPI:1982114559
Name:CONEJO VALLEY TRANSIT, LLC
Entity Type:Organization
Organization Name:CONEJO VALLEY TRANSIT, LLC
Other - Org Name:CONEJO VALLEY TRANSIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER /MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMAKOLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-880-8780
Mailing Address - Street 1:22141 VENTURA BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1672
Mailing Address - Country:US
Mailing Address - Phone:818-880-8780
Mailing Address - Fax:818-518-1332
Practice Address - Street 1:22141 VENTURA BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1672
Practice Address - Country:US
Practice Address - Phone:818-880-8780
Practice Address - Fax:818-518-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)