Healthcare Provider Details

I. General information

NPI: 1689540973
Provider Name (Legal Business Name): CIARA JAYDEN WELBOURNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1399
US

IV. Provider business mailing address

911 HORNBECK PL
SOLVANG CA
93463-2240
US

V. Phone/Fax

Practice location:
  • Phone: 805-568-4118
  • Fax: 720-467-8846
Mailing address:
  • Phone: 720-467-8846
  • Fax: 720-467-8846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPPS-XROAWN
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: