NPIMap

Individual provider Active NPI

Liliana Camacho, PA-C

  • Physician Assistant
  • Moorpark, CA
National Provider Identifier
1154823748
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55356 Issued in CA
Practice address
4279 Tierra Rejada Rd
Moorpark, CA 93021-3775
Phone
(805) 222-2323
Fax
(805) 222-2333
NPI assigned
Feb 28, 2018
Last updated
Apr 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55356 CA Primary

Addresses

Primary practice location

4279 Tierra Rejada Rd
Moorpark, CA 93021-3775

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180509002488 CA Practitioner - Physician Assistant 6709140205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

2921 Saviers Rd
Oxnard, CA 93033-5314
Phone (805) 487-5588

422 Arneill Rd B
Camarillo, CA 93010-6434
Phone (805) 383-4510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55356CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince May 7, 2018 Accepting new patients
Clinicas del Camino Real Inc CurrentSince May 7, 2018 Accepting new patients
Community Memorial Health System CurrentSince Dec 1, 2021 Accepting new patients
Community Memorial Health System CurrentSince Dec 1, 2021 Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

4279 Tierra Rejada Rd
Moorpark, CA 93021
Phone (805) 222-2323

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Interoperability endpoints

  • Direct secure messaging: lcamacho3518468@oc.providencedirect.org
  • Direct secure messaging: lilianacamacho@cfh.allscriptsdirect.net

Organizations & group practices 8

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1154823748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 TIERRA REJADA RD",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213775",
            "telephone_number": "805-222-2323",
            "fax_number": "805-222-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "LILIANA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

Verify at the official NPI Registry.