=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811839533
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOPHIA WILLIS-CONGER LMFT
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 E VICTORIA ST STE F
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93101-8734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-242-6495
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1522
-----------------------------------------------------
City | SUMMERLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93067-1522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-424-7300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 148947
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------