Healthcare Provider Details

I. General information

NPI: 1831798594
Provider Name (Legal Business Name): OPEN MINDS SB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2020
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 LIGHTHOUSE RD
SANTA BARBARA CA
93109-1908
US

IV. Provider business mailing address

312 LIGHTHOUSE RD
SANTA BARBARA CA
93109-1908
US

V. Phone/Fax

Practice location:
  • Phone: 805-633-0849
  • Fax: 805-626-8785
Mailing address:
  • Phone: 805-633-0849
  • Fax: 805-626-8785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALESSANDRA STARCZAK FLEMING
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 805-633-0849