Healthcare Provider Details

I. General information

NPI: 1427905611
Provider Name (Legal Business Name): EQUICARE CONSULTANT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 HOPE TERRACE CT
SANTA MARIA CA
93455-3840
US

IV. Provider business mailing address

671 HOPE TERRACE CT
SANTA MARIA CA
93455-3840
US

V. Phone/Fax

Practice location:
  • Phone: 805-975-7176
  • Fax:
Mailing address:
  • Phone: 805-975-7176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOLE IRENE BENNETT
Title or Position: CEO
Credential: MPH
Phone: 805-975-7176