Healthcare Provider Details

I. General information

NPI: 1316419898
Provider Name (Legal Business Name): LANI ELIZABETH FOX RN, BSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E ANAPAMU ST
SANTA BARBARA CA
93101-2000
US

IV. Provider business mailing address

98 S PATTERSON AVE APT 102
SANTA BARBARA CA
93111-2056
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-4200
  • Fax:
Mailing address:
  • Phone: 805-994-6159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number599154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: