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General NPI Number Information
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NPI Number | 1689748048
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Entity Type | Individual
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Provider Name | MS. ISLAH MOHARRAM
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 2034 DE LA VINA ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3814
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Country | US
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Telephone | 805-884-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 5043 WALNUT PARK DR
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City | SANTA BARBARA
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State | CA
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Zip | 93111-1837
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Country | US
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Telephone | 805-884-6850
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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 | 43274
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License Number State | CA
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