1497298814 NPI number — SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497298814 NPI number — SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS
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:
6
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:
1497298814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 W FOSTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA MARIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93455-3620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-934-6542
Provider Business Mailing Address Fax Number:
805-934-6314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4263 CALIFORNIA BLVD
Provider Second Line Business Practice Location Address:
OUTSIDE PORTABLE ARRC ROOM
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93455-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-934-6542
Provider Business Practice Location Address Fax Number:
805-934-6314
Provider Enumeration Date:
12/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SUMMERS
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
QCM COORDINATOR
Authorized Official Telephone Number:
805-681-5450

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X , 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)





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