| |
621 Chapala St Ste C Santa Barbara CA 93101-7010 | |
(805) 377-3734 | |
(805) 335-6856 |
Full Name | |
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Speciality | Psychologist |
Location | 621 Chapala St Ste C, Santa Barbara, California |
Authorized Official Name and Position | Lauren L Guy (CEO) |
Authorized Official Contact | 8053773734 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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621 Chapala St Ste C Santa Barbara CA 93101-7010 Ph: (805) 377-3734 | 621 Chapala St Ste C Santa Barbara CA 93101-7010 Ph: (805) 377-3734 |
NPI Number | 1548839129 |
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Provider Enumeration Date | 06/18/2021 |
Last Update Date | 08/16/2021 |
Certification Date | 08/16/2021 |
Medicare PECOS PAC ID | 1355746207 |
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Medicare Enrollment ID | O20210816003541 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548839129 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Lauren Guy |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1033304159 PECOS PAC ID: 9638393523 Enrollment ID: I20140616001725 |
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