Conejo Valley Primary Healthcare

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

CONEJO VALLEY PRIMARY HEALTHCARE

Practice address

1429 E Thousand Oaks Blvd # 108
Thousand Oaks, CA 91362-2801

Phone

(805) 719-1700

Fax

(805) 719-1711

NPI assigned

May 3, 2023

Last updated

May 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lynn Coates-Leisen, FNP-CNPI 1134523558

Title

Ceo

Phone

(818) 642-7162

Specialties & licenses 1

Addresses

Other names 1

• Lynn Coates-Leisen, NP Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lynn Coates-Leisen, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Thousand Oaks, CA
  • NPI 1134523558
  Medicare reassignment NPD Authorized official
• Morvarid Yousefi, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Silver Spring, MD
  • NPI 1699926410
  NPD
• Richard Park, M.D.

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1174718134
  NPD (past)

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1265121446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 E THOUSAND OAKS BLVD # 108",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913622801",
            "telephone_number": "805-719-1700",
            "fax_number": "805-719-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 E THOUSAND OAKS BLVD # 108",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913622801",
            "telephone_number": "805-719-1700",
            "fax_number": "805-719-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEJO VALLEY PRIMARY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "COATES-LEISEN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-642-7162",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynn Coates-Leisen, NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Conejo Valley Dialysis, Inc. (Conejo Valley Renal Center)
• Conejo Valley Electrophysiology Inc.
• Conejo Valley Mtu
• Conejo Valley Multispecialty Medical Group
• Conejo Valley Physical Therapy, Inc
• Conejo Valley Unified School District
• Conejo Valley Women's Resource Center
• Conejo Women's Health, Inc.
• Conejomedtrans,Inc
• Connection Point Freight Carriers LLC

• Health Service Clinic/Center in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.