Healthcare Provider Details

I. General information

NPI: 1265756803
Provider Name (Legal Business Name): MELISSA JONES CANTEKIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 STATE STREET SUITE 3-G
SANTA BARBARA CA
93101-6752
US

IV. Provider business mailing address

1129 STATE STREET SUITE 3-G
SANTA BARBARA CA
93101-6752
US

V. Phone/Fax

Practice location:
  • Phone: 805-965-9508
  • Fax:
Mailing address:
  • Phone: 805-965-9508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberCAPSY#22622
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberCAPSY#22622
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberCAPSY#22622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: