Basic Information
| Provider Information | |||||||||
| NPI: | 1942389457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VERICA | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | ALOYSIUS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3924 MARICOPA DR | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058981424 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 429 N SAN ANTONIO RD | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058841600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 03/28/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC 46345 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.