Healthcare Provider Details

I. General information

NPI: 1265471528
Provider Name (Legal Business Name): DR. JUDY CATHRYN DEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDY CATHRYN DEAN M.D.

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 E VALLEY RD
SANTA BARBARA CA
93108-2106
US

IV. Provider business mailing address

1525 STATE ST STE 102
SANTA BARBARA CA
93101-6510
US

V. Phone/Fax

Practice location:
  • Phone: 805-565-5907
  • Fax:
Mailing address:
  • Phone: 805-560-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG44016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: