Healthcare Provider Details

I. General information

NPI: 1275612814
Provider Name (Legal Business Name): TERESA SUZETTE EDDY RN, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1399
US

IV. Provider business mailing address

849 MISSION CANYON RD
SANTA BARBARA CA
93105-2171
US

V. Phone/Fax

Practice location:
  • Phone: 805-884-1608
  • Fax:
Mailing address:
  • Phone: 805-901-5697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW 17520
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number566522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: