Provider Demographics
NPI:1750873113
Name:VENTURA COUNTY COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:VENTURA COUNTY COMMUNITY COLLEGE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, STUDENTS HEALTH PROGRAM
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:805-378-1413
Mailing Address - Street 1:7075 CAMPUS ROAD
Mailing Address - Street 2:STUDENT HEALTH SERVICES
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1605
Mailing Address - Country:US
Mailing Address - Phone:805-378-1413
Mailing Address - Fax:805-378-1570
Practice Address - Street 1:7075 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1605
Practice Address - Country:US
Practice Address - Phone:805-378-1413
Practice Address - Fax:805-378-1570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VENTURA COUNTY COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-01
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health