Free Clinic of Simi Valley

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

050000088 Issued in CA

Legal business name

FREE CLINIC OF SIMI VALLEY

Practice address

2060 Tapo St.
Simi Valley, CA 93063-3417

Phone

(805) 522-3733

Fax

(805) 522-9576

NPI assigned

Jan 26, 2010

Last updated

Jan 26, 2010By 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

Mrs. Adriana Trujillo, RN

Title

Administrator

Phone

(805) 522-3733

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Free Clinic of Simi Valley2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Free Clinic of Simi Valley

  • Voluntary or Charitable Agency
  • Simi Valley, CA
  • NPI 1710438197
  NPD tax ID

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.

• Soo Ahn, PHARM.D.

  • Ambulatory Care Pharmacist
  • Simi Valley, CA
  • NPI 1992245971
  NPD (past)
• Robert L Deamer, PHARMD, BCPS

  • Pharmacotherapy Pharmacist
  • Simi Valley, CA
  • NPI 1972836047
  NPD (past)
• Jennifer Haigh

  • Mental Health Counselor
  • Simi Valley, CA
  • NPI 1952891194
  NPD (past)

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1801127162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 TAPO ST.",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633417",
            "telephone_number": "805-522-3733",
            "fax_number": "805-522-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 TAPO ST.",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633417",
            "telephone_number": "805-522-3733",
            "fax_number": "805-522-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE CLINIC OF SIMI VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "TRUJILLO",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-522-3733",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "050000088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL",
            "identifier": "DUN#197915861",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Drake Fraser, LMFT
• Fratt Dental Corporation (Brightnow Simi Valley)
• Kristin Fredrickson, MA MFT
• Free Again Consulting
• Free Clinic of Simi Valley
• Free Motion Therapeutics & Physical Therapy Inc.
• Free Spirit Hospice, Inc.
• Karynne Fricke, M.A. CCC-SLP
• Marvin Friedman, PHARM.D.
• Serena Maye Friedman, M.D.

• Family Medicine Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.