Healthcare Provider Details

I. General information

NPI: 1699239962
Provider Name (Legal Business Name): PETITE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W PUEBLO ST
SANTA BARBARA CA
93105-4230
US

IV. Provider business mailing address

510 W PUEBLO ST
SANTA BARBARA CA
93105-4230
US

V. Phone/Fax

Practice location:
  • Phone: 805-845-1221
  • Fax: 805-845-1224
Mailing address:
  • Phone: 805-845-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARISH LEANN BARRY
Title or Position: OWNER
Credential: MD
Phone: 805-845-1221