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5412 Carpinteria Ave Carpinteria CA 93013-1423 | |
(805) 696-1002 | |
(805) 696-1003 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 5412 Carpinteria Ave, Carpinteria, California |
Authorized Official Name and Position | Deonna Elizabeth Perez (COO) |
Authorized Official Contact | 8056817356 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3227 State St Santa Barbara CA 93105-3328 Ph: (805) 681-7356 | 5412 Carpinteria Ave Carpinteria CA 93013-1423 Ph: (805) 696-1002 |
NPI Number | 1487204244 |
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Provider Enumeration Date | 09/13/2019 |
Last Update Date | 09/06/2022 |
Identifier | Type | State | Issuer |
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1487204244 | NPI | - | NPPES |
FHC70786F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |