Healthcare Provider Details

I. General information

NPI: 1598836215
Provider Name (Legal Business Name): VALENTIN IGNACIO OLVERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 CHAPALA ST
SANTA BARBARA CA
93105-3902
US

IV. Provider business mailing address

4886 PAYTON STREET
SANTA BARBARA CA
93111
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-1607
  • Fax:
Mailing address:
  • Phone: 805-683-4612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: