Healthcare Provider Details

I. General information

NPI: 1740704592
Provider Name (Legal Business Name): LAURA HERGET DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 HOLLISTER AVE
SANTA BARBARA CA
93111-2389
US

IV. Provider business mailing address

PO BOX 62106
SANTA BARBARA CA
93160-2106
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-7781
  • Fax:
Mailing address:
  • Phone: 805-681-1760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number039479-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number301985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: