Basic Information
| Provider Information | |||||||||
| NPI: | 1083244248 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYLES | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | NOEL | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 226 W VALERIO ST APT B | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931014825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039199129 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 W PUEBLO ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931054353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056827111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2020 | ||||||||
| LastUpdateDate: | 07/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA57758 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.