BRENT STREET FAMILY PRACTICE (NPI# 1063565604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063565604 |
| Entity Type | Organization |
| Organization Name | BRENT STREET FAMILY PRACTICE |
| Practice Address |
168 N Brent St Ste 502 Ventura CA 93003-2817 |
| Practice Telephone | 8056412000 |
| Practice Fax Number | 8056531644 |
| Mailing Telephone | 8056412000 |
| Mailing Fax Number | 8056531644 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT F DODGE (PRESIDENT) |
| Authorized Official Telephone | 8056412000 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | G40594 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | G26650 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | G46052 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | G43925 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G266500 | 05 | |
| CA | 00G405940 | 05 | |
| CA | 00G439250 | 05 | |
| CA | 00G460520 | 05 |
| Street Address |
168 N BRENT ST STE 502 |
| City | VENTURA |
| State | CA |
| Zip Code | 93003-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919133 | Jeffrey C Brackett | Internal Medicine | 168 N Brent St, Ste 503, Ventura, CA 93003-2840 | 2005-06-01 |
| 1932731866 | Sally F Mcnally | Advanced Practice Midwife | 168 N Brent St, Ventura, CA 93003-2817 | 2020-02-08 |
| 1710367693 | Stephan Sweet, M.d. Inc. | Orthopaedic Surgery | 168 N Brent St, Ste 505, Ventura, CA 93003-2817 | 2015-06-04 |
| 1518363001 | Robert T Mazurek M D A Professional | Specialist | 168 N Brent St, Suite 501, Ventura, CA 93003-2817 | 2014-11-10 |
| 1013312594 | Antulio B Aroche Jr Do A Professional Corporation | Orthopaedic Surgery | 168 N Brent St, Suite 505, Ventura, CA 93003-2817 | 2014-10-27 |
| 1861738718 | Diane Jeanne Milstead | Advanced Practice Midwife | 168 N Brent St, 407, Ventura, CA 93003-2817 | 2012-12-21 |
| 1699011569 | Ventura County Neurosurgery Associates Medical Group | Neurological Surgery | 168 N Brent St, Suite 408, Ventura, CA 93003-2817 | 2012-12-21 |
| 1083950018 | David L. Westra, Md, A Professional Corporation | Neurological Surgery | 168 N Brent St, Suite 408, Ventura, CA 93003-2817 | 2012-12-19 |
| 1164768107 | Michael J Dorsi, M.d., A Professional Corporation | Neurological Surgery | 168 N Brent St, Suite 408, Ventura, CA 93003-2817 | 2012-12-19 |
| 1164766291 | Tracy Ann Lyou | Nurse Practitioner | 168 N Brent St, Suite 502, Ventura, CA 93003-2817 | 2012-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
| 1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
| 1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
| 1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
| 1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
| 1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
| 1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
| 1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
| 1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
| 1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
| Find all providers in zip 93003 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841640919 | Sa Vanna Baker Leyva | Family Medicine | 143 Shamrock Dr, Ventura, CA 93003-3148 | 2016-06-20 |
| 1548654296 | Victor Duong | Family Medicine | 2772 Johnson Dr Ste 200, Ventura, CA 93003-7262 | 2015-03-20 |
| 1720322613 | Philip Alva Schofield | Family Medicine | 648 Via Ondulando, Ventura, CA 93003-1327 | 2012-11-16 |
| 1063732758 | Ian Wallace | Family Medicine | 3291 Loma Vista Rd Rm 120, Ventura, CA 93003-3099 | 2010-06-04 |
| 1598928962 | Steve K Jones M.d.,inc | Family Medicine | 7721 Redondo St, Ventura, CA 93004-3813 | 2008-07-07 |
| 1508028192 | David T Perlmutter | Family Medicine | 7916 Stone St, Ventura, CA 93004-4025 | 2008-06-25 |
| 1245376854 | J Bruce Barbosa | Family Medicine | 2945 Loma Vista Road, Ventura, CA 93003-2915 | 2007-01-30 |
| 1932251436 | Jeffrey King, Md, A Professional Corporation | Family Medicine | 3438 Loma Vista Rd, Ventura, CA 93003-3026 | 2007-01-17 |
| 1053477646 | Wendy Francke | Family Medicine | 133 W Santa Clara St, Ventura, CA 93001-2543 | 2006-12-28 |
| 1104988898 | Desiree Domingo-foraste | Family Medicine | 970 Petit Ave Ste D, Ventura, CA 93004-2215 | 2006-12-16 |
| Find all providers in VENTURA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.