Healthcare Provider Details
I. General information
NPI: 1801044169
Provider Name (Legal Business Name): BERNARD NJUGUNA PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/28/2008
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
186 CAMINO DE VIDA APT C
SANTA BARBARA CA
93111-2226
US
IV. Provider business mailing address
186 CAMINO DE VIDA APT C
SANTA BARBARA CA
93111-2226
US
V. Phone/Fax
- Phone: 805-708-4508
- Fax:
- Phone: 805-708-4508
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: