Samuel Jefferson, is a
Student In An Organized Health Care Education/training Program based in Camarillo, California. Samuel Jefferson is licensed to practice in * (Not Available) (license number ) and his current practice location is
1756 S Lewis Rd, Camarillo, California. He can be reached at his office (for appointments etc.) via phone at
(805) 383-3669.
NPI number for Samuel Jefferson is 1548928898 and his current mailing address is 5284 Adolfo Rd Ste 100, Camarillo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1548928898.
Healthcare Provider's Profile
| Full Name | Samuel Jefferson |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1756 S Lewis Rd, Camarillo, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1548928898
- Provider Enumeration Date: 12/03/2021
- Last Update Date: 10/24/2024
Medical Identifiers
Medical identifiers for Samuel Jefferson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548928898 | NPI | - | NPPES |
| 56CC | Other | CA | ASPIRA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Jefferson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Samuel Jefferson,
5284 Adolfo Rd Ste 100,
Camarillo, CA 93012-6790
Ph: (805) 289-0120 | Samuel Jefferson,
1756 S Lewis Rd,
Camarillo, CA 93012-8520
Ph: (805) 383-3669 |
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