Healthcare Provider Details

I. General information

NPI: 1154032035
Provider Name (Legal Business Name): CORINNE JO CURTIS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 OAK ST STE 203
SOLVANG CA
93463-3725
US

IV. Provider business mailing address

PO BOX 838
SANTA YNEZ CA
93460-0838
US

V. Phone/Fax

Practice location:
  • Phone: 805-570-0288
  • Fax:
Mailing address:
  • Phone: 805-687-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY19025
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY19025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: