Basic Information
| Provider Information | |||||||||
| NPI: | 1245454750 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LONGO | ||||||||
| FirstName: | CECILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 91321 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931901321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057293338 | ||||||||
| FaxNumber: | 8057331213 | ||||||||
| Practice Location | |||||||||
| Address1: | 22 W MICHELTORENA ST STE B | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931016525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057293338 | ||||||||
| FaxNumber: | 8057331213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LMFT86591 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.