Individual
DR. JILLANNE W. MCCARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1280 S VICTORIA AVE STE 160, VENTURA, CA 93003-6504
(805) 658-3937
(805) 658-3930
Mailing address
1280 S VICTORIA AVE STE 160, VENTURA, CA 93003-6504
(805) 658-3937
(805) 658-3930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G64125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G641250
—
CA
01
—
010622759
TAX ID
CA
01
—
G64125
STATE LIC.
CA
Enumeration date
09/27/2006
Last updated
03/07/2023
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