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General NPI Number Information
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NPI Number | 1417126426
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Entity Type | Individual
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Provider Name | ELIZABETH ANN KELLEHER M.A.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2008
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Last Update Date | 12/15/2024
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Provider Practice Location Address
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Address Line | 2565 PUESTA DEL SOL
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City | SANTA BARBARA
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State | CA
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Zip | 93105-2936
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Country | US
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Telephone | 805-395-8848
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Fax |
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Provider Business Mailing Address
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Address Line | 133 E VALERIO ST
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City | SANTA BARBARA
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State | CA
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Zip | 93101-1913
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Country | US
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Telephone | 805-637-7505
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF 52157
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 149078
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License Number State | CA
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