Healthcare Provider Details

I. General information

NPI: 1265591762
Provider Name (Legal Business Name): SANTA BARBARA COUNTY MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W. FOSTER ROAD
SANTA MARIA CA
93455
US

IV. Provider business mailing address

500 W. FOSTER ROAD
SANTA MARIA CA
93455
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-6385
  • Fax: 805-934-6539
Mailing address:
  • Phone: 805-934-6385
  • Fax: 805-934-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. EPIMAQUIO SALDIVAR GOMEZ
Title or Position: PRACTITIONER INTERN
Credential: MA
Phone: 805-934-6385