Healthcare Provider Details

I. General information

NPI: 1649925934
Provider Name (Legal Business Name): COTTAGE CLINICAL NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3885 STATE ST STE A
SANTA BARBARA CA
93105-5645
US

IV. Provider business mailing address

PO BOX 689
SANTA BARBARA CA
93102-0689
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-7351
  • Fax:
Mailing address:
  • Phone: 805-682-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TARYN O'CONNELL
Title or Position: ADMINISTRATIVE DIRECTOR, OPERATIONS
Credential:
Phone: 805-729-8013