Healthcare Provider Details

I. General information

NPI: 1063328078
Provider Name (Legal Business Name): EMILY MACDONELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 W MICHELTORENA ST
SANTA BARBARA CA
93101-4131
US

IV. Provider business mailing address

414 E COTA ST
SANTA BARBARA CA
93101-1624
US

V. Phone/Fax

Practice location:
  • Phone: 805-963-1546
  • Fax: 805-324-5173
Mailing address:
  • Phone: 805-617-7857
  • Fax: 805-618-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95041144
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: