Healthcare Provider Details

I. General information

NPI: 1033373873
Provider Name (Legal Business Name): TMHA SANTA MARIA WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 INGER DR STE 101A
SANTA MARIA CA
93454-8665
US

IV. Provider business mailing address

PO BOX 15408
SAN LUIS OBISPO CA
93406-5408
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-0139
  • Fax: 805-928-1410
Mailing address:
  • Phone: 805-541-5144
  • Fax: 805-541-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA E. HARNEY
Title or Position: CLINICAL DIRECTOR
Credential: LMFT
Phone: 805-720-2536