1407877566 NPI number — FAMILY SERVICE AGENCY OF SANTA BARBARA COUNTY

Table of content: (NPI 1407877566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407877566 NPI number — FAMILY SERVICE AGENCY OF SANTA BARBARA COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY SERVICE AGENCY OF SANTA BARBARA COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407877566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 W GUTIERREZ ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93101-3424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 W GUTIERREZ 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-965-1001
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRABO
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
805-965-1001

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21301 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 21305 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 21304 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 0032670 . This is a "STATE TAX IDENTIFICATION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 21302 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 21303 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 21306 . This is a "MEDICAL REPORTING UNIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".