Provider First Line Business Practice Location Address:
122 W VALERIO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-2973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-389-4764
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2026