Healthcare Provider Details

I. General information

NPI: 1932568151
Provider Name (Legal Business Name): LAVENTANA TREATMENT PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2016
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 LA VISTA RD
SANTA BARBARA CA
93110-1236
US

IV. Provider business mailing address

275 E HILLCREST DR SUITE 120
THOUSAND OAKS CA
91360-5827
US

V. Phone/Fax

Practice location:
  • Phone: 805-777-3873
  • Fax: 805-777-9226
Mailing address:
  • Phone: 805-777-3873
  • Fax: 805-777-9226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JOANN ZUNIGA
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 805-558-0374