| Telecare Vista | |
|
4601 Telephone Rd Ste 117 Ventura CA 93003-5672 | |
| (805) 642-7033 | |
| (805) 642-7732 |
| Full Name | Telecare Vista |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4601 Telephone Rd Ste 117, Ventura, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5107470552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Vista 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare Vista 4601 Telephone Rd Ste 117 Ventura CA 93003-5672 Ph: (805) 642-7033 |
| NPI Number | 1760692750 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760692750 | NPI | - | NPPES |
| 56BF | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
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