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NPI Code Detail

MEDICARE: SYMBRIA COULTAS APCC

MEDICARE: SYMBRIA COULTAS APCC
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
1101YP2500XProfessional Counselor13188CA

General Provider Information

NPI Number : 1467227504
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYMBRIA COULTAS APCC
Provider Business Mailing Address
First Line : 6649 CEDROS AVE
Second Line :
City : VAN NUYS
State : CA
Zip : 91405-3862
Country : US
Telephone Number : 240-625-6965
Fax Number :
Provider Business Practice Location Address
First Line : 1836 STATE ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-2420
Country : US
Telephone Number : 805-453-6190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 11/20/2023

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Directions to “ SYMBRIA COULTAS APCC” Practice Location

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