Basic Information
Provider Information
NPI: 1306048905
EntityType: 2
ReplacementNPI:  
OrganizationName: COMMUNITY ACTION COMMISSION OF SANTA BARBARA COUNTY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: COMMUNIFY
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5638 HOLLISTER AVE STE 230
Address2:  
City: GOLETA
State: CA
PostalCode: 931173474
CountryCode: US
TelephoneNumber: 8059648857
FaxNumber:  
Practice Location
Address1: 201 W CHAPEL ST
Address2:  
City: SANTA MARIA
State: CA
PostalCode: 934584303
CountryCode: US
TelephoneNumber: 8059222243
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2007
LastUpdateDate: 01/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALMANZA
AuthorizedOfficialFirstName: NUVIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MENTAL HEALTH PRACTITIONER
AuthorizedOfficialTelephone: 8059648857
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: AMFT
NPICertificationDate: 01/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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