Healthcare Provider Details

I. General information

NPI: 1538788633
Provider Name (Legal Business Name): KATHERINE STUART DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE STUART

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PESETAS LN
SANTA BARBARA CA
93110-1416
US

IV. Provider business mailing address

PO BOX 62106
SANTA BARBARA CA
93160-2106
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-7500
  • Fax:
Mailing address:
  • Phone: 805-681-1760
  • Fax: 805-681-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: