| Santa Maria Tay Fsp Program | |
|
2370 Skyway Dr Suite 104 Santa Maria CA 93455-1133 | |
| (805) 934-1487 | |
| Not Available |
| Full Name | Santa Maria Tay Fsp Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2370 Skyway Dr, Santa Maria, California |
| Authorized Official Name and Position | Tammy Lynn Casiano (QCM COORDINATOR) |
| Authorized Official Contact | 8053255905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Maria Tay Fsp Program 315 Camino Del Remedio Santa Barbara CA 93110-1332 Ph: (805) 681-5330 | Santa Maria Tay Fsp Program 2370 Skyway Dr Suite 104 Santa Maria CA 93455-1133 Ph: (805) 934-1487 |
| NPI Number | 1619421252 |
|---|---|
| Provider Enumeration Date | 08/11/2016 |
| Last Update Date | 01/07/2021 |
| Certification Date | 01/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619421252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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