Healthcare Provider Details

I. General information

NPI: 1740762244
Provider Name (Legal Business Name): SHENANDOAH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 W MISSION ST STE 4
SANTA BARBARA CA
93101-0401
US

IV. Provider business mailing address

30 W MISSION ST STE 4
SANTA BARBARA CA
93101-0401
US

V. Phone/Fax

Practice location:
  • Phone: 52-841-1498
  • Fax:
Mailing address:
  • Phone: 805-284-1149
  • Fax: 805-284-1149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number133476
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: