Healthcare Provider Details

I. General information

NPI: 1114565900
Provider Name (Legal Business Name): SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 CARMEN LN STE 104
SANTA MARIA CA
93458-7776
US

IV. Provider business mailing address

5385 HOLLISTER AVE BLDG 14
SANTA BARBARA CA
93111-2389
US

V. Phone/Fax

Practice location:
  • Phone: 805-554-3002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE DIAZ
Title or Position: QUALITY CARE MANAGEMENT
Credential: MA
Phone: 805-934-6344