1679587224 NPI number — GOLETA VALLEY COTTAGE HOSPITAL

Table of content: (NPI 1679587224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679587224 NPI number — GOLETA VALLEY COTTAGE HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOLETA VALLEY COTTAGE HOSPITAL
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:
1679587224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 689
Provider Second Line Business Mailing Address:
C/O FINANCE DEPARTMENT
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93102-0689
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-879-8964
Provider Business Mailing Address Fax Number:
805-879-8945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
351 S PATTERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GOLETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93111-2403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-967-3411
Provider Business Practice Location Address Fax Number:
805-681-6437
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRICHER
Authorized Official First Name:
JOAN
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT FINANCE/CFO
Authorized Official Telephone Number:
805-569-7294

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  050000034 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: LTC55617F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LTC70106F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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