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CIVISTA WOMEN'S HEALTH CENTER
NPI 1831417476
Clinic/Center - Multi-Specialty in Waldorf, MD

Active since May 06, 2010
11315 PEMBROOKE SQ STE 111, WALDORF, MD 20603(301) 843-3150(301) 843-2560 Get Directions Write a Review

NPPES record last updated: December 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Civista Women's Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CIVISTA WOMEN'S HEALTH CENTER (NPI 1831417476) is a healthcare organization registered as a multi-specialty in Waldorf, Maryland and active in the NPI registry since May 2010. The organization lists Ivette M Montes De Oca, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1831417476
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameCIVISTA CLINICAL SERVICES LLC
Location Address11315 PEMBROOKE SQ STE 111Waldorf, MD 20603-4806
Mailing Address5 Garrett Avenue, Po Box 1070La Plata, MD 20646-1070 · (301) 609-4000
Phone(301) 843-3150
Fax(301) 843-2560
Organization SubpartYesParent: Civista Medical Center
Authorized OfficialIvette M Montes De OcaPractice Manager · (301) 843-3150
Enumeration DateMay 6, 2010
Last NPPES UpdateDecember 17, 2019
✔ NPI 1831417476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in MD · D0065304
11315 PEMBROOKE SQ STE 111, Waldorf, MD 20603
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Other Names 1

Doing Business AsCivista Women's Health Center

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SHAWNEE LAKAI THOMAS CRNP
Nurse Practitioner (Family)
11315 PEMBROOKE SQ STE 111
WALDORF, MD 20603
Charles County (240) 252-2150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Civista Clinical Services LLC's NPI number?

The NPI number for Civista Clinical Services LLC is 1831417476. It was assigned to this organization in the NPPES registry on May 6, 2010. The provider is doing business as Civista Women's Health Center.

Where is Civista Clinical Services LLC located?

Civista Clinical Services LLC is located at 11315 Pembrooke Sq Ste 111, Waldorf, MD 20603. The listed phone number is (301) 843-3150.

What is Civista Clinical Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Civista Clinical Services LLC was last updated on December 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.