Healthcare Provider Details
I. General information
NPI: 1114707585
Provider Name (Legal Business Name): HAVEN FAMILY RESOURCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 N LA CUMBRE RD STE H
SANTA BARBARA CA
93110-2592
US
IV. Provider business mailing address
200 N LA CUMBRE RD STE H
SANTA BARBARA CA
93110-2592
US
V. Phone/Fax
- Phone: 805-834-2229
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SABRINA
FREIDENFELDS
Title or Position: FOUNDING DIRECTOR
Credential: MPH, IBCLC, PMH-C
Phone: 805-834-2229