Healthcare Provider Details

I. General information

NPI: 1205901733
Provider Name (Legal Business Name): COMMUNITY ACTION COMMISSION OF SANTA BARBARA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FOSTER RD CHILDREN'S MISC CLINIC
SANTA MARIA CA
93455-3620
US

IV. Provider business mailing address

5638 HOLLISTER AVE SUITE 230
GOLETA CA
93117-3474
US

V. Phone/Fax

Practice location:
  • Phone: 805-260-4676
  • Fax: 805-934-6525
Mailing address:
  • Phone: 805-964-8857
  • Fax: 805-934-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. FRAN FORMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-964-8857