Basic Information
Provider Information
NPI: 1023156858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WESTERMAN
FirstName: WANDA
MiddleName: S.
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 62106
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931602106
CountryCode: US
TelephoneNumber: 8056811761
FaxNumber: 8056811768
Practice Location
Address1: 317 W PUEBLO ST
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931054355
CountryCode: US
TelephoneNumber: 8056811761
FaxNumber: 8056811768
Other Information
ProviderEnumerationDate: 02/02/2007
LastUpdateDate: 01/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XBRN12359CAN Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 
367A00000XNP1486CAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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