=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801037783
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VILLA MAJELLA OF SANTA BARBARA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2009
-----------------------------------------------------
Last Update Date | 03/23/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 604 N KELLOGG AVE
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93111-1437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-683-2838
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 60029
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93160-0029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-964-1650
-----------------------------------------------------
Fax | 805-964-2117
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. JEANETTE FRANCES NADEAU
-----------------------------------------------------
Credential | MSW
-----------------------------------------------------
Telephone | 805-964-1650
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------