Healthcare Provider Details

I. General information

NPI: 1265611016
Provider Name (Legal Business Name): JOSH IVAN MORLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E MICHELTORENA ST
SANTA BARBARA CA
93101-1905
US

IV. Provider business mailing address

1403 BATH ST E
SANTA BARBARA CA
93101-6676
US

V. Phone/Fax

Practice location:
  • Phone: 805-965-3434
  • Fax:
Mailing address:
  • Phone: 310-733-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: