Healthcare Provider Details

I. General information

NPI: 1982028049
Provider Name (Legal Business Name): CIERRA WEST BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N B ST
LOMPOC CA
93436-6901
US

IV. Provider business mailing address

117 N B ST
LOMPOC CA
93436-6901
US

V. Phone/Fax

Practice location:
  • Phone: 805-315-9070
  • Fax: 805-737-6601
Mailing address:
  • Phone: 805-315-9070
  • Fax: 805-737-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717002053
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: