| Ppsbvslo | |
|
518 Garden Street Santa Barbara CA 93101 | |
| (805) 963-2445 | |
| (805) 965-2292 |
| Full Name | Ppsbvslo |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 518 Garden Street, Santa Barbara, California |
| Authorized Official Name and Position | Jenna Tosh (PRESIDENT/CEO) |
| Authorized Official Contact | 8059632445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppsbvslo 518 Garden Street Santa Barbara CA 93101 Ph: (805) 963-2445 | Ppsbvslo 518 Garden Street Santa Barbara CA 93101 Ph: (805) 963-2445 |
| NPI Number | 1811926058 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 09/30/2023 |
| Certification Date | 09/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811926058 | NPI | - | NPPES |
| CMM70384F | Medicaid | CA | |
| CMM70373F | Medicaid | CA | |
| ZZT11744F | Medicaid | CA | |
| CMM70003F | Medicaid | CA | |
| CMM71102F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | () | Primary |
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