Healthcare Provider Details

I. General information

NPI: 1780841114
Provider Name (Legal Business Name): CHERYL LYNN ANGLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E MICHELTORENA ST
SANTA BARBARA CA
93101-1905
US

IV. Provider business mailing address

1342 SAN RAFAEL AVE
SANTA BARBARA CA
93109-2052
US

V. Phone/Fax

Practice location:
  • Phone: 805-965-3434
  • Fax:
Mailing address:
  • Phone: 805-965-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: