Healthcare Provider Details

I. General information

NPI: 1104538883
Provider Name (Legal Business Name): AMY WINSLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 DE LA VINA ST
SANTA BARBARA CA
93101-3114
US

IV. Provider business mailing address

PO BOX 551
SANTA BARBARA CA
93102-0551
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-2785
  • Fax:
Mailing address:
  • Phone: 805-569-2785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: