Healthcare Provider Details

I. General information

NPI: 1922260546
Provider Name (Legal Business Name): GEORGINA DAHILL MA,MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E CANON PERDIDO ST STE 207B
SANTA BARBARA CA
93101-2283
US

IV. Provider business mailing address

222 E CANON PERDIDO ST STE 207B
SANTA BARBARA CA
93101-2283
US

V. Phone/Fax

Practice location:
  • Phone: 805-680-5264
  • Fax:
Mailing address:
  • Phone: 805-965-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT53509
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 53509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: