Basic Information
Provider Information | |||||||||
NPI: | 1376874966 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | SANTA BARBARA COUNTY EDUCATION OFFICE - HEALTH LINKAGES PROGRAM | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3970 LA COLINA RD | ||||||||
Address2: | ROOM 6 | ||||||||
City: | SANTA BARBARA | ||||||||
State: | CA | ||||||||
PostalCode: | 931101563 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8059644710 | ||||||||
FaxNumber: | 8056824646 | ||||||||
Practice Location | |||||||||
Address1: | 3970 LA COLINA RD | ||||||||
Address2: | ROOM 6 | ||||||||
City: | SANTA BARBARA | ||||||||
State: | CA | ||||||||
PostalCode: | 931101563 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8059644710 | ||||||||
FaxNumber: | 8056824646 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/20/2010 | ||||||||
LastUpdateDate: | 01/20/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | LOWE | ||||||||
AuthorizedOfficialFirstName: | GEORGENE | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | COORDINATOR, HEALTH LINKAGES PROGRA | ||||||||
AuthorizedOfficialTelephone: | 8059644710 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | SANTA BARBARA COUNTY EDUCATION OFFICE | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | RN | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251300000X |   |   | Y |   | Agencies | Local Education Agency (LEA) |   |
No ID Information.