Healthcare Provider Details

I. General information

NPI: 1053966077
Provider Name (Legal Business Name): MARGARET LOUISE ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 GARDEN ST
SANTA BARBARA CA
93101-1459
US

IV. Provider business mailing address

PO BOX 28
SANTA BARBARA CA
93102-0028
US

V. Phone/Fax

Practice location:
  • Phone: 805-730-7575
  • Fax:
Mailing address:
  • Phone: 805-730-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number106500000X
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: