Individual
ALLISON LYNN WASTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C, RN, CCRN
Contact information
Practice address
1910 OUTLET CENTER DR, OXNARD, CA 93036-0677
(805) 485-2400
(805) 485-3025
Mailing address
1910 OUTLET CENTER DR, OXNARD, CA 93036-0677
(805) 485-2400
(805) 485-3025
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172720
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-029
TRICARE/CHAMPUS
VA
01
—
1093197923
USA MANAGED CARE
VA
05
—
1093197923
—
NC
05
—
1093197923
—
VA
Enumeration date
06/27/2015
Last updated
05/07/2024
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