Healthcare Provider Details

I. General information

NPI: 1831585827
Provider Name (Legal Business Name): AMY CLAIRE GAULTNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY CLAIRE EHMAN

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BATH ST
SANTA BARBARA CA
93105-4324
US

IV. Provider business mailing address

PO BOX 689
SANTA BARBARA CA
93102-0689
US

V. Phone/Fax

Practice location:
  • Phone: 805-879-4240
  • Fax: 805-566-3037
Mailing address:
  • Phone: 805-879-4240
  • Fax: 805-566-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberA156065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA156065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: