Individual provider Active NPI

Liz Otterbein

  • Psychiatric/Mental Health Registered Nurse
  • Ventura, CA
National Provider Identifier
1639367709
Registry record updated Oct 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
501039 Issued in CA
Practice address
200 Hillmont Ave
Ventura, CA 93003-1647
Phone
(805) 652-6729
NPI assigned
Oct 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 501039 CA Primary

Addresses

Primary practice location

200 Hillmont Ave
Ventura, CA 93003-1647

Mailing address

200 Hillmont Ave
Ventura, CA 93003-1647
Phone (805) 652-6729

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

State licenses

LicenseStateTypeSpecialty
501039CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1192233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192233600000",
    "number": "1639367709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031647",
            "telephone_number": "805-652-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031647",
            "telephone_number": "805-652-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERBEIN",
        "first_name": "LIZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-13",
        "last_updated": "2007-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "501039",
            "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 Oct 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.