MEDICARE: MS. MARILYN GELLENS BUTTERFIELD RN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	12	CA
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	223004	CA

General Provider Information

NPI Number	:	1538686092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN GELLENS BUTTERFIELD RN

Provider Business Mailing Address
First Line	:	4444 CALLE REAL
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93110-1002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 E DE LA GUERRA ST # 193
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2228
Country	:	US
Telephone Number	:	925-953-4089
Fax Number	:

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

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	06/16/2018

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