Provider Demographics
NPI:1083719397
Name:LUCEY, SARAH BULLARD (MFI)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BULLARD
Last Name:LUCEY
Suffix:
Gender:F
Credentials:MFI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 HIGH RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108
Mailing Address - Country:US
Mailing Address - Phone:805-565-9966
Mailing Address - Fax:805-565-9966
Practice Address - Street 1:1131 HIGH RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108
Practice Address - Country:US
Practice Address - Phone:805-565-9966
Practice Address - Fax:805-565-9966
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 29415106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9714OtherUS BEH HEALTH
CAZZZ418867OtherBLUE SHIELD