Healthcare Provider Details

I. General information

NPI: 1215227244
Provider Name (Legal Business Name): KATYA ADACHI SERRANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 CENTERPOINTE PKWY
SANTA MARIA CA
93455-1334
US

IV. Provider business mailing address

300 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1316
US

V. Phone/Fax

Practice location:
  • Phone: 805-346-7230
  • Fax:
Mailing address:
  • Phone: 805-681-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberA124695
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA124695
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA124695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: