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General NPI Number Information
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NPI Number | 1932506755
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Entity Type | Organization
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Legal Business Name | DEVEREUX CALIFORNIA
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 6980 FALBERG WAY
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City | GOLETA
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State | CA
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Zip | 93117
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Country | US
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Telephone | 805-968-2525
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Fax | 805-968-3247
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Provider Business Mailing Address
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Address Line | PO BOX 6784
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City | SANTA BARBARA
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State | CA
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Zip | 93160-6784
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Country | US
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Telephone | 805-968-2525
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Fax | 805-968-3247
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. AMY M EVANS
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Credential | MA, LMFT,
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Telephone | 805-968-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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