Provider First Line Business Practice Location Address:
508 W JUNIPERO ST APT C
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:
93105-4295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-729-2379
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2026