Provider Demographics
NPI:1174792196
Name:ARMENDARIZ, BETHANY KAREN (RN, WHCNP, CNM)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:KAREN
Last Name:ARMENDARIZ
Suffix:
Gender:F
Credentials:RN, WHCNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 MADRESELVA CT
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-6816
Mailing Address - Country:US
Mailing Address - Phone:714-290-1061
Mailing Address - Fax:
Practice Address - Street 1:461 MADRESELVA CT
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-6816
Practice Address - Country:US
Practice Address - Phone:714-290-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-24
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17064363LW0102X
CA1748367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health