Provider First Line Business Practice Location Address:
1084 VIA REGINA
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:
93111-1340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-729-7982
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2026