Basic Information
| Provider Information | |||||||||
| NPI: | 1962600296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NARAYANAN | ||||||||
| FirstName: | VEENA | ||||||||
| MiddleName: | S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 CAMINO DE CELESTE | ||||||||
| Address2: | |||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913607119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054928080 | ||||||||
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| Practice Location | |||||||||
| Address1: | 975 FLYNN RD | ||||||||
| Address2: | |||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930128704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053887740 | ||||||||
| FaxNumber: | 8054820987 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS12019 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.