Healthcare Provider Details

I. General information

NPI: 1417815481
Provider Name (Legal Business Name): CHANNEL ISLANDS YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 EUGENIA PL STE 104
CARPINTERIA CA
93013-2000
US

IV. Provider business mailing address

1180 EUGENIA PL STE 104
CARPINTERIA CA
93013-2000
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-1103
  • Fax:
Mailing address:
  • Phone: 805-569-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: CINDY DORENE HALSTEAD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 805-569-1103