Active NPI
Jorge R Avila Martinez, RPH
- Pharmacotherapy Pharmacist
- Ventura, CA
National Provider Identifier
1417537507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 59531
- Practice address
- 147 N Brent St
Ventura, CA 93003-2854 - Phone
- (805) 652-5011
- NPI assigned
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 59531 | CA | Primary |
Addresses
Primary practice location
147 N Brent St
Ventura, CA 93003-2854
Mailing address
1777 Alta Vista PL
Camarillo, CA 93012-4077
Phone (818) 203-3910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59531 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1417537507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 ALTA VISTA PL",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930124077",
"telephone_number": "818-203-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 N BRENT ST",
"city": "VENTURA",
"state": "CA",
"postal_code": "930032854",
"telephone_number": "805-652-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA MARTINEZ",
"first_name": "JORGE",
"middle_name": "R",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CA",
"license": "59531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.