Healthcare Provider Details

I. General information

NPI: 1396194445
Provider Name (Legal Business Name): MARY AYANNA BOYCE MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 WEST PUEBLO STREET CANCER CENTER OF SANTA BARBARA WITH SANSUM CLINIC
SANTA BARBARA CA
93105
US

IV. Provider business mailing address

601 E MICHELTORENA STREET UNIT 92
SANTA BARBARA CA
93103
US

V. Phone/Fax

Practice location:
  • Phone: 805-563-5828
  • Fax:
Mailing address:
  • Phone: 805-637-0146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC000767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: