Healthcare Provider Details

I. General information

NPI: 1558038786
Provider Name (Legal Business Name): CLARISA BRASIL ENES NONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 HOLLISTER AVE BLDG 2 & 3
GOLETA CA
93111
US

IV. Provider business mailing address

5385 HOLLISTER AVE BLDG 2 & 3
GOLETA CA
93111
US

V. Phone/Fax

Practice location:
  • Phone: 805-725-0649
  • Fax:
Mailing address:
  • Phone: 805-725-0649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: