Healthcare Provider Details

I. General information

NPI: 1467882936
Provider Name (Legal Business Name): CENTER FOR DEVELOPMENTAL PLAY AND LEARNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 VIA LOS SANTOS
SANTA BARBARA CA
93111-1346
US

IV. Provider business mailing address

4675 VIA LOS SANTOS
SANTA BARBARA CA
93111-1346
US

V. Phone/Fax

Practice location:
  • Phone: 805-964-2700
  • Fax: 805-964-2722
Mailing address:
  • Phone: 805-964-2700
  • Fax: 805-964-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberMFC 36439
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 14111
License Number StateCA

VIII. Authorized Official

Name: PATRICIA DEINES MARQUART
Title or Position: PRESIDENT
Credential: MFT
Phone: 805-729-2051