NPIMap

Organization Active NPI

Pdap of Ventura County, Inc.

  • Community/Behavioral Health Agency
  • Camarillo, CA
National Provider Identifier
1972623007
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
560015EN Issued in CA
Legal business name
PDAP OF VENTURA COUNTY, INC.
Practice address
450 Rosewood Avenue
Suite 215
Camarillo, CA 93010-5914
Phone
(805) 482-1265
Fax
(805) 389-5295
NPI assigned
Mar 30, 2007
Reactivated
Apr 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Virginia Mary Connell, MFT
Title
Executive Director
Phone
(805) 482-1265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 560015EN CA Primary

Addresses

Primary practice location

450 Rosewood Avenue
Suite 215
Camarillo, CA 93010-5914

Mailing address

1029 E Santa Paula St
Santa Paula, CA 93060-2247
Phone (805) 482-1265

Other identifiers 1

IdentifierTypeStateIssuer
5673MedicaidCA

Other names 1

  • Palmer Drug Abuse Program of Ventura County, Inc. Other name

National Provider Directory

National Provider Directory
Tax ID family
Pdap of Ventura County11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

450 Rosewood Ave
Ste 215
Camarillo, CA 93010

1029 E Santa Paula St
Santa Paula, CA 93060

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1972623007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 E SANTA PAULA ST",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930602247",
            "telephone_number": "805-482-1265",
            "fax_number": "805-389-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ROSEWOOD AVENUE",
            "address_2": "SUITE 215",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105914",
            "telephone_number": "805-482-1265",
            "fax_number": "805-389-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDAP OF VENTURA COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-04-18",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "805-482-1265",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "560015EN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5673",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer Drug Abuse Program of Ventura County, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.