VERICARE OF CALIFORNIA MEDICAL GROUP (NPI# 1689629198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689629198 |
| Entity Type | Organization |
| Organization Name | VERICARE OF CALIFORNIA MEDICAL GROUP |
| Other Organization Name | VERICARE |
| Practice Address |
205 Granada St Camarillo CA 93010-7715 |
| Mailing Address |
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8003703651 |
| Mailing Fax Number | 8775157147 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-07-11 |
| NPI Deactivation Date | 04/11/2007 |
| NPI Reactivation Date | 2007-08-08 |
| Authorized Official Name | MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT) |
| Authorized Official Telephone | 8003703651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GPS000150 | 05 | |
| CA | RAILROAD MEDICARE | CH5753 | 01 |
| Other Name | Type Code |
|---|---|
| Vericare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114053 | Vericare of California Medical Group | Social Worker | 325 Kempton St, Spring Valley, CA 91977-5810 | 2006-05-23 |
| 1316992829 | Vericare of California Medical Group | Social Worker | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2006-05-23 |
| 1275588790 | Vericare of California Medical Group | Social Worker | 1835 W La Veta Ave, Orange, CA 92868-4132 | 2006-05-23 |
| 1164475299 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-18 |
| 1528011764 | Vericare of California Medical Group | Social Worker | 81 Professional Ctr Pkwy, San Rafael, CA 94903-2797 | 2006-05-18 |
| 1407047673 | Vericare of California Medical Group | Nurse Practitioner | 3293 N Drinkwater Blvd, Scottsdale, AZ 85251-6405 | 2007-08-05 |
| 1760437271 | Vericare of California Medical Group | Social Worker | 1505 Colby Dr, Glendale, CA 91205-3307 | 2006-05-23 |
| 1194779439 | Vericare of California Medical Group | Social Worker | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2006-05-20 |
| 1104879980 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-19 |
| 1942254644 | Vericare of California Medical Group | Social Worker | 430 Willow St, Alameda, CA 94501-6130 | 2006-05-19 |
| Street Address |
205 GRANADA ST |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-7715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215924725 | Camarillo Community Care, Inc. | Skilled Nursing Facility | 205 Granada St, Camarillo, CA 93010-7715 | 2005-09-29 |
| 1972068997 | Claire Alexandra Cowley | Speech-Language Pathologist | 205 Granada St, Camarillo, CA 93010-7715 | 2019-02-04 |
| 1831653575 | Nikita Sunny | Occupational Therapist | 205 Granada St, Camarillo, CA 93010-7715 | 2019-01-28 |
| 1336603208 | Lacey Chrystal Smith | Occupational Therapist | 205 Granada St, Camarillo, CA 93010-7715 | 2019-01-24 |
| 1003359183 | Candice Bugh | Occupational Therapist | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-22 |
| 1154863785 | Antonio Escudero | Physical Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-14 |
| 1598207177 | Gabriel Alcala | Physical Therapist | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-14 |
| 1184166829 | Latoya Ecuyer | Occupational Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-11 |
| 1811439698 | Philip Samaniego | Physical Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-10 |
| 1881136562 | Lisa Devillers | Occupational Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093194136 | Lisa M. Barra | Psychologist | 80 N Wood Rd, Ste 306, Camarillo, CA 93010-8310 | 2015-05-21 |
| 1427313535 | Ashley Ribeiro | Psychologist | 1601 Carmen Dr Ste 201, Camarillo, CA 93010-3103 | 2012-07-05 |
| 1215236674 | Priscilla Partridge De Garcia | Psychologist | 520 Camino Concordia, Camarillo, CA 93010-8417 | 2011-03-23 |
| 1306171830 | Laura R. Addison | Psychologist | 621 Via Alondra, Suite 611a, Camarillo, CA 93012-8095 | 2009-10-16 |
| 1952550808 | Kimberly Ann Dorsett | Psychologist | 400 W Ventura Blvd Ste 230, Camarillo, CA 93010-9142 | 2008-09-16 |
| 1285790360 | Tracy S Bennett | Psychologist | 340 Rosewood Ave, Camarillo, CA 93010-5927 | 2006-12-31 |
| 1497201537 | Katherine Hamilton, Ph.d., A California Psychology Corporation | Psychologist | 1000 Paseo Camarillo Ste 114, Camarillo, CA 93010-0751 | 2016-08-29 |
| 1164869582 | Jill Lynn Moland | Psychologist | 360 Mobil Ave, Ste 214, Camarillo, CA 93010-6444 | 2013-05-24 |
| 1699027581 | Darla E Dixon | Psychologist | 975 Flynn Rd, Camarillo, CA 93012-8704 | 2012-10-03 |
| 1508137647 | Dr. Deborah Digiaro Psychologist, Inc. | Psychologist | 1601 Carmen Dr, Suite 106, Camarillo, CA 93010-3105 | 2012-01-20 |
| Find all providers in CAMARILLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.