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General NPI Number Information
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NPI Number | 1265458434
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Entity Type | Organization
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Legal Business Name | SANTA BARBARA NEIGHBORHOOD CLINICS
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 970 EMBARCADERO DEL MAR
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City | ISLA VISTA
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State | CA
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Zip | 93117-4869
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Country | US
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Telephone | 805-968-1511
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Fax | 805-968-7041
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Provider Business Mailing Address
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Address Line | 915 N MILPAS ST 2ND FLOOR
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2331
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Country | US
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Telephone | 805-617-7858
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Fax | 805-963-8880
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. CHARLES CAMILLO FENZI
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Credential | M.D.
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Telephone | 805-617-7850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 050000089
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License Number State | CA
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