Provider Demographics
NPI:1053637470
Name:MILES, ANN LESLIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:LESLIE
Last Name:MILES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 ALAMEDA PADRE SERRA
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1756
Mailing Address - Country:US
Mailing Address - Phone:805-350-3908
Mailing Address - Fax:
Practice Address - Street 1:2020 ALAMEDA PADRE SERRA
Practice Address - Street 2:STE 211
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-1756
Practice Address - Country:US
Practice Address - Phone:805-350-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17722103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical