Basic Information
| Provider Information | |||||||||
| NPI: | 1063532620 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLEISCHER | ||||||||
| FirstName: | RHONDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5740 RALSTON ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930036009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052893198 | ||||||||
| FaxNumber: | 8052893201 | ||||||||
| Practice Location | |||||||||
| Address1: | 5740 RALSTON ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930036009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052893198 | ||||||||
| FaxNumber: | 8052893201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 167G00000X | PT24401 | CA | Y | Nursing Service Providers | Licensed Psychiatric Technician |
No ID Information.