Healthcare Provider Details

I. General information

NPI: 1154902948
Provider Name (Legal Business Name): TRAILE PHYLLIS EASLAND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 LA COLINA RD STE 2
SANTA BARBARA CA
93110-4502
US

IV. Provider business mailing address

2424 BORTON DR
SANTA BARBARA CA
93109-1838
US

V. Phone/Fax

Practice location:
  • Phone: 805-570-7770
  • Fax:
Mailing address:
  • Phone: 805-570-7770
  • Fax: 805-845-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number521328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: