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General NPI Number Information
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NPI Number | 1124359005
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Entity Type | Individual
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Provider Name | SHELLEY HART PPS
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Gender | Female
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Dates
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Enumeration Date | 01/17/2010
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Last Update Date | 01/17/2010
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Provider Practice Location Address
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Address Line | 429 N SAN ANTONIO RD
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City | SANTA BARBARA
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State | CA
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Zip | 93110-1399
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Country | US
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Telephone | 805-884-1629
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Fax |
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Provider Business Mailing Address
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Address Line | 704 BOLTON WALK APT #101
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City | GOLETA
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State | CA
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Zip | 93117-4183
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Country | US
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Telephone | 530-902-4205
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 050208099
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License Number State | CA
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