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General NPI Number Information
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NPI Number | 1043059223
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Entity Type | Organization
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Legal Business Name | IMAGINE PSYCHOTHERAPY & CONSULTING, INC
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 5276 HOLLISTER AVE STE 406
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City | SANTA BARBARA
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State | CA
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Zip | 93111-3097
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Country | US
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Telephone | 805-500-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 STONECREEK RD UNIT B
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4656
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Country | US
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Telephone | 805-286-5057
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARLEEN MARY O'BRIEN
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Credential | PSYD
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Telephone | 805-500-6654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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