Healthcare Provider Details

I. General information

NPI: 1962020271
Provider Name (Legal Business Name): SHELLEY N OSBORN LIC CLINICAL PSYCHOLOGIST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 STATE ST STE 20
SANTA BARBARA CA
93101-2536
US

IV. Provider business mailing address

1515 STATE ST STE 20
SANTA BARBARA CA
93101-2536
US

V. Phone/Fax

Practice location:
  • Phone: 805-963-6500
  • Fax:
Mailing address:
  • Phone: 805-963-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELLEY NICOLE OSBORN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 805-963-6500