Basic Information
| Provider Information | |||||||||
| NPI: | 1023449691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RISSER | ||||||||
| FirstName: | SONIA | ||||||||
| MiddleName: | MARIEL | ||||||||
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| Credential: | AMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2034 DE LA VINA ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931053814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056815450 | ||||||||
| FaxNumber: | 8058846888 | ||||||||
| Practice Location | |||||||||
| Address1: | 2034 DE LA VINA ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931053814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056815450 | ||||||||
| FaxNumber: | 8058846888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2013 | ||||||||
| LastUpdateDate: | 11/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | AMFT83749 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.