Provider Demographics
NPI:1285497727
Name:PACHECO, ONYX ONASIN ONASIN
Entity type:Individual
Prefix:
First Name:ONYX ONASIN
Middle Name:ONASIN
Last Name:PACHECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6545
Mailing Address - Country:US
Mailing Address - Phone:805-419-4863
Mailing Address - Fax:
Practice Address - Street 1:390 FULTON ST
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6545
Practice Address - Country:US
Practice Address - Phone:805-419-4863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565850355374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide