MEDICARE: MR. CRAIG ROBERT PENNER MA

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	106H00000X	Marriage & Family Therapist	MFC17516	CA

General Provider Information

NPI Number	:	1871579284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRAIG ROBERT PENNER MA

Provider Business Mailing Address
First Line	:	331 SHERMAN RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-1649
Country	:	US
Telephone Number	:	805-965-2287
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 E VICTORIA ST
Second Line	:	SUITE B
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2619
Country	:	US
Telephone Number	:	805-966-7794
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/08/2007

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