Healthcare Provider Details

I. General information

NPI: 1467349795
Provider Name (Legal Business Name): CARL ANGELO LLANOS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

IV. Provider business mailing address

711 W ORTEGA ST APT 5
SANTA BARBARA CA
93101-4477
US

V. Phone/Fax

Practice location:
  • Phone: 805-450-1618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95099208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: