Healthcare Provider Details

I. General information

NPI: 1497897656
Provider Name (Legal Business Name): ALICE CHRISTINA GEANTA-THOMAS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S LA CUMBRE STE 200
SANTA BARBARA CA
93105
US

IV. Provider business mailing address

PO BOX 30841
SANTA BARBARA CA
93130-0841
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-8622
  • Fax:
Mailing address:
  • Phone: 805-350-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number80297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: