Healthcare Provider Details

I. General information

NPI: 1467653444
Provider Name (Legal Business Name): COUNTY OF SANTA ADMHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FOSTER RD
SANTA MARIA CA
93455-3620
US

IV. Provider business mailing address

500 W FOSTER RD
SANTA MARIA CA
93455-3620
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-6380
  • Fax:
Mailing address:
  • Phone: 805-934-6380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberIMF52268
License Number StateCA

VIII. Authorized Official

Name: DONA LEE COBELENS
Title or Position: MOBILE CRISIS PRACTITIONERCOUNSELOR
Credential: IMF
Phone: 805-450-3965