1982114559 NPI number — CONEJO VALLEY TRANSIT, LLC

Table of content: MS. DEBRA VELETA FOSTER LPC (NPI 1497915706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982114559 NPI number — CONEJO VALLEY TRANSIT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONEJO VALLEY TRANSIT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CONEJO VALLEY TRANSIT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982114559
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22141 VENTURA BLVD
Provider Second Line Business Mailing Address:
SUITE 302
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91364-1672
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-880-8780
Provider Business Mailing Address Fax Number:
818-518-1332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22141 VENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91364-1672
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-880-8780
Provider Business Practice Location Address Fax Number:
818-518-1332
Provider Enumeration Date:
10/09/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KEMAKOLAM
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MANAGER /MEMBER
Authorized Official Telephone Number:
818-880-8780

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)