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735 State St Ste 527 Santa Barbara CA 93101-5554 | |
| (805) 455-2804 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 735 State St Ste 527, Santa Barbara, California |
| Authorized Official Name and Position | Jill Ann Frandsen (PRESIDENT) |
| Authorized Official Contact | 8054552804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
735 State St Ste 527 Santa Barbara CA 93101-5554 Ph: (805) 455-2804 | 735 State St Ste 527 Santa Barbara CA 93101-5554 Ph: (805) 455-2804 |
| NPI Number | 1346922895 |
|---|---|
| Provider Enumeration Date | 08/03/2023 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 2062959125 |
|---|---|
| Medicare Enrollment ID | O20240807000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346922895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jill A Frandsen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1821347147 PECOS PAC ID: 4385095371 Enrollment ID: I20240807000614 |
| Provider Name | Joe Gonzalez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831216712 PECOS PAC ID: 7517405384 Enrollment ID: I20240813000192 |
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