Liliana Camacho, PA-C
Individual provider Active NPI Physician Assistant · Moorpark, CA
NPI 1154823748 · NPPES record last updated Apr 26, 2018
Key facts
- NPI
- 1154823748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA55356 (CA)
- Practice address
- 4279 Tierra Rejada Rd
Moorpark, CA 93021-3775 - Phone
- (805) 222-2323
- Fax
- (805) 222-2333
- NPI assigned
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Memorial Health System
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
- Community Memorial Hospital - Ventura
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180509002488 | CA | Practitioner - Physician Assistant | 6709140205 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA55356 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinicas del Camino Real Inc | Current |
Accepting new patients | |
| Community Memorial Health System | Current |
Accepting new patients | |
| Community Memorial Health System | Current |
Accepting new patients | |
| Clinicas del Camino Real Inc | Current |
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
5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469
138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850
147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011
Interoperability endpoints
- lcamacho3518468@oc.providencedirect.org
- lilianacamacho@cfh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA55356 | CA | Yes |
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
Other providers in Moorpark, CA
- Burts Pharmacy Moorpark
- Burts Pharmacy Moorpark
- Ca Ya Services LLC
- Ca Ya Services LLC
- California Kidney Medical Group, Inc
- Marie Campbell
- Katrina Camus
- David Canale
- Kimberly Cano
- Carolyn Jean Carr
All providers in Moorpark, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.