Provider Demographics
NPI:1053509208
Name:AMERICAN INDIAN HEALTH AND SERVICES
Entity Type:Organization
Organization Name:AMERICAN INDIAN HEALTH AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETIITIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DIGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:805-681-7356
Mailing Address - Street 1:4141 STATE ST
Mailing Address - Street 2:SUITE A1
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1814
Mailing Address - Country:US
Mailing Address - Phone:805-681-7356
Mailing Address - Fax:805-681-7352
Practice Address - Street 1:4141 STATE ST
Practice Address - Street 2:SUITE A1
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1814
Practice Address - Country:US
Practice Address - Phone:805-681-7356
Practice Address - Fax:805-681-7352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA944250305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service