Basic Information
| Provider Information | |||||||||
| NPI: | 1427295492 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORTER | ||||||||
| FirstName: | JOAN | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2020 ALAMEDA PADRE SERRA | ||||||||
| Address2: | STE 211 | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931031761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055408555 | ||||||||
| FaxNumber: | 8053244913 | ||||||||
| Practice Location | |||||||||
| Address1: | 4444 CALLE REAL | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056814789 | ||||||||
| FaxNumber: | 8056815239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2009 | ||||||||
| LastUpdateDate: | 05/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFT46392 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.