Healthcare Provider Details

I. General information

NPI: 1932647336
Provider Name (Legal Business Name): FAMILY SERVICE AGENCY OF SANTA BARBARA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N LINCOLN ST
SANTA MARIA CA
93458
US

IV. Provider business mailing address

123 W GUTIERREZ ST
SANTA BARBARA CA
93101-3424
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-1707
  • Fax: 805-922-4797
Mailing address:
  • Phone: 805-965-1001
  • Fax: 805-965-2178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA BRABO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-965-1001