Healthcare Provider Details

I. General information

NPI: 1750509014
Provider Name (Legal Business Name): THE PHOENIX HOUSE OF SANTA BARBARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7170 DAVENPORT RD 108
GOLETA CA
93117-2955
US

IV. Provider business mailing address

7170 DAVENPORT RD 108
GOLETA CA
93117-2955
US

V. Phone/Fax

Practice location:
  • Phone: 805-636-3135
  • Fax:
Mailing address:
  • Phone: 805-636-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. MESUT INCI
Title or Position: QMHW
Credential: MA, MFT INTERN
Phone: 805-636-3135