Healthcare Provider Details

I. General information

NPI: 1497238596
Provider Name (Legal Business Name): LOUISE OLGA FRADENBURG JOY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DE LA VINA ST STE F
SANTA BARBARA CA
93101-5164
US

IV. Provider business mailing address

1215 DE LA VINA ST STE F
SANTA BARBARA CA
93101-5164
US

V. Phone/Fax

Practice location:
  • Phone: 805-895-1847
  • Fax:
Mailing address:
  • Phone: 805-895-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: