Individual provider Active NPI

Jo Ann Angcanan Samonte, FNP

  • Family Nurse Practitioner
  • Camarillo, CA
National Provider Identifier
1124151642
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN395917 Issued in CA
Practice address
1722 S Lewis Rd
Camarillo, CA 93012-8520
Phone
(805) 445-7832
Fax
(805) 987-7237
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN395917 CA Primary

Addresses

Primary practice location

1722 S Lewis Rd
Camarillo, CA 93012-8520

Mailing address

1990 Regent St
Camarillo, CA 93010-4573
Phone (805) 987-4215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326000784 CA Practitioner - Nurse Practitioner 9335586353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN395917CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Feb 11, 2024 Accepting new patients
County of Ventura CurrentSince Feb 11, 2024 Accepting new patients

Locations

612 Spring Rd
Bldg A
Moorpark, CA 93021
Phone (805) 523-5400

2400 S C St
Oxnard, CA 93033
Phone (805) 240-7000

800 S Victoria Ave
#L4640
Ventura, CA 93009

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124151642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 REGENT ST",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930104573",
            "telephone_number": "805-987-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-445-7832",
            "fax_number": "805-987-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMONTE",
        "first_name": "JO ANN",
        "middle_name": "ANGCANAN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN395917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.