Basic Information
Provider Information
NPI: 1528732534
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANTANA
FirstName: REBECCA
MiddleName: CECILIA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 115 S LA CUMBRE LN STE 200
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931055104
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1722 S LEWIS RD
Address2:  
City: CAMARILLO
State: CA
PostalCode: 930128520
CountryCode: US
TelephoneNumber: 8053664040
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2021
LastUpdateDate: 08/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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