Doctor Name: | PROF. SAMANTHA JOANN VENABLE |
NPI Number: | 1902002892 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 311697 |
Business Practice Address: | 20901 Porter Ranch Rd Trabuco Canyon, CA - 926793363 |
Business Phone Number: | 9495896708 |
Business Fax Number: | 9495893638 |
Mailing Address: | 20901 Porter Ranch Rd, TRABUCO CANYON |
State: | CA |
Postal Code: | 926793363 |
Phone Number: | 9495896708 |
Fax Number: | 9495893638 |
NPI Enumeration Date: | 06/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 311697 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |