Provider Demographics
NPI:1003822768
Name:GOERWITZ, KURT (PHD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:GOERWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DE LA VINA STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101
Mailing Address - Country:US
Mailing Address - Phone:805-966-5165
Mailing Address - Fax:805-957-9612
Practice Address - Street 1:1215 DE LA VINA STREET
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101
Practice Address - Country:US
Practice Address - Phone:805-966-5165
Practice Address - Fax:805-957-9612
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5295103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP5295Medicare ID - Type Unspecified