Healthcare Provider Details

I. General information

NPI: 1295325819
Provider Name (Legal Business Name): KRISTIN CARA DEHAHN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W PUEBLO ST
SANTA BARBARA CA
93105-4230
US

IV. Provider business mailing address

PO BOX 62106
SANTA BARBARA CA
93160-2106
US

V. Phone/Fax

Practice location:
  • Phone: 773-573-9721
  • Fax:
Mailing address:
  • Phone: 805-681-1760
  • Fax: 805-681-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95016449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: