Bic Brain Injury Home at Banner Ave

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BIC BRAIN INJURY HOME AT BANNER AVE

Practice address

50 Banner Ave
Ventura, CA 93004-1551

Phone

(805) 482-1312

Fax

(805) 456-7876

NPI assigned

Apr 30, 2024

Organization subpart

Yes

Parent organization

BRAIN INJURY CENTER OF VENTURA COUNTYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anna Jeanette Gendron, MS, ARF, CBIS

Title

Assistant Administrator

Phone

(805) 482-1312

Specialties & licenses 1

Addresses

Part of

Bic Brain Injury Home at Banner Ave

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1053168971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BANNER AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041551",
            "telephone_number": "805-482-1312",
            "fax_number": "805-456-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BANNER AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041551",
            "telephone_number": "805-482-1312",
            "fax_number": "805-456-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIC BRAIN INJURY HOME AT BANNER AVE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRAIN INJURY CENTER OF VENTURA COUNTY",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "GENDRON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "JEANETTE",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "805-482-1312",
        "authorized_official_credential": "MS, ARF, CBIS"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A. Beuttler, M.D.
• Beverly Gardens Family Therapy Inc
• Jessica Anne Frodsham Beving, M.S., LMFT
• Erik Bezema, MD
• Ruchi Bhan, DDS
• Robert Bickerstaff
• Jessica S Bickford, MS, RD, CDE
• Juanita Bigheart
• Mackenzie Bilane
• Jonathan Bill, LAC LICENSED ACUPUNC

• Assisted Living Facility in Ventura, CA
• Providers in Ventura, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.