Basic Information
| Provider Information | |||||||||
| NPI: | 1851940001 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SB CTY DEPT OF BEHAVIORAL WELLNESS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5385 HOLLISTER AVE BLDG 14 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931112389 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 CARMEN LN | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934587775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059346344 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2019 | ||||||||
| LastUpdateDate: | 09/10/2019 | ||||||||
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| AuthorizedOfficialLastName: | DIAZ | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | QUALITY CARE MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 8059346344 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MA | ||||||||
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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.