MEDICARE: BIENESTAR CCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1295451938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIENESTAR CCC

Provider Business Mailing Address
First Line	:	5088 SAN LORENZO DR
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93111-2614
Country	:	US
Telephone Number	:	805-470-8290
Fax Number	:

Provider Business Practice Location Address
First Line	:	5088 SAN LORENZO DR
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93111-2614
Country	:	US
Telephone Number	:	805-470-8290
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	ALEJANDRA CORTES
Credential	:	LMFT
Telephone Number	:	805-470-8290

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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Directions to “BIENESTAR CCC ” Practice Location

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