MEDICARE: DR. ANDREA GURNEY PH.D.

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	103T00000X	Psychologist	PSY20875	CA
2	103TC1900X	Counseling Psychologist	PSY20875	CA
3	103TC2200X	Clinical Child & Adolescent Psychologist	PSY20875	CA
4	103TF0000X	Family Psychologist	PSY20875	CA
5	106H00000X	Marriage & Family Therapist	PSY20875	CA

General Provider Information

NPI Number	:	1477701811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA GURNEY PH.D.

Provider Business Mailing Address
First Line	:	955 LA PAZ RD
Second Line	:	DEPT. OF PSYCHOLOGY
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-1023
Country	:	US
Telephone Number	:	805-565-6057
Fax Number	:	805-565-6116

Provider Business Practice Location Address
First Line	:	1187 COAST VILLAGE RD
Second Line	:	SUITE 10G
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2737
Country	:	US
Telephone Number	:	805-565-6057
Fax Number	:	805-565-6116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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