Healthcare Provider Details

I. General information

NPI: 1033311097
Provider Name (Legal Business Name): COMMUNITY ACTION COMMISSION OF SANTA BARBARA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 TOGNAZZINI AVE
GUADALUPE CA
93434-1526
US

IV. Provider business mailing address

5638 HOLLISTER AVE STE 230
GOLETA CA
93117-3474
US

V. Phone/Fax

Practice location:
  • Phone: 805-343-1670
  • Fax:
Mailing address:
  • Phone: 805-964-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRAN FORMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-964-8857