Healthcare Provider Details

I. General information

NPI: 1639670094
Provider Name (Legal Business Name): KAI ROLDAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 STATE ST
SANTA BARBARA CA
93101-3301
US

IV. Provider business mailing address

615 STATE ST
SANTA BARBARA CA
93101-3301
US

V. Phone/Fax

Practice location:
  • Phone: 805-617-0478
  • Fax:
Mailing address:
  • Phone: 805-617-0478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: