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NPI Code Detail

MEDICARE: MARY WADDELL FIELD

MEDICARE:   MARY WADDELL FIELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1619480779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY WADDELL FIELD
Provider Business Mailing Address
First Line : 617 GARDEN ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-1664
Country : US
Telephone Number : 805-884-8440
Fax Number :
Provider Business Practice Location Address
First Line : 7167 ALAMEDA AVE
Second Line :
City : GOLETA
State : CA
Zip : 93117-1354
Country : US
Telephone Number : 805-685-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2017
Last Update Date : 11/13/2017

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Directions to “ MARY WADDELL FIELD ” Practice Location

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