Basic Information
| Provider Information | |||||||||
| NPI: | 1669946166 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUPLES INSTITUTE OF SANTA BARBARA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2020 ALAMEDA PADRE SERRA STE 211 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931031761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055408555 | ||||||||
| FaxNumber: | 8053244913 | ||||||||
| Practice Location | |||||||||
| Address1: | 2020 ALAMEDA PADRE SERRA STE 211 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931031761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055408555 | ||||||||
| FaxNumber: | 8053244913 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2019 | ||||||||
| LastUpdateDate: | 01/17/2019 | ||||||||
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| AuthorizedOfficialLastName: | PORTER | ||||||||
| AuthorizedOfficialFirstName: | JOAN | ||||||||
| AuthorizedOfficialMiddleName: | ALEXANDRA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 8055408555 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.