Healthcare Provider Details

I. General information

NPI: 1063086486
Provider Name (Legal Business Name): JESSE WOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 BATH ST STE 315
SANTA BARBARA CA
93105-4387
US

IV. Provider business mailing address

PO BOX 689
SANTA BARBARA CA
93102-0689
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-7236
  • Fax: 805-563-7281
Mailing address:
  • Phone: 805-569-7236
  • Fax: 805-563-7281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA195846
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA195846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: