Healthcare Provider Details
I. General information
NPI: 1518528983
Provider Name (Legal Business Name): CHRISTIAN LEWIS FEIST LMFT, 137730
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/26/2019
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4810 FOOTHILL RD
CARPINTERIA CA
93013-3073
US
IV. Provider business mailing address
123 W GUTIERREZ ST
SANTA BARBARA CA
93101-3424
US
V. Phone/Fax
- Phone: 805-325-3203
- Fax:
- Phone: 805-965-1001
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 111310 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 137730 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: