Basic Information
| Provider Information | |||||||||
| NPI: | 1083008734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARRIDO-VIDAL | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 371 | ||||||||
| Address2: | 2228 LILLIE AVE #3 | ||||||||
| City: | SUMMERLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930670371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609658756 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2034 DE LA VINA ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058846850 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2015 | ||||||||
| LastUpdateDate: | 03/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | PCCI 339 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.