Healthcare Provider Details

I. General information

NPI: 1235752510
Provider Name (Legal Business Name): MEGAN MARIE KOOYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 CHAPALA ST
SANTA BARBARA CA
93101-3116
US

IV. Provider business mailing address

720 SANTA BARBARA ST
SANTA BARBARA CA
93101-2232
US

V. Phone/Fax

Practice location:
  • Phone: 805-965-2376
  • Fax:
Mailing address:
  • Phone: 805-963-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number116706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: