Provider Demographics
NPI:1083824312
Name:SOUTH COUNTY SHIA
Entity Type:Organization
Organization Name:SOUTH COUNTY SHIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHIA COLLABORATIVE PROGRAM MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:805-884-8030
Mailing Address - Street 1:22 W MISSION ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2450
Mailing Address - Country:US
Mailing Address - Phone:805-884-8030
Mailing Address - Fax:805-884-8031
Practice Address - Street 1:22 W MISSION ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2450
Practice Address - Country:US
Practice Address - Phone:805-884-8030
Practice Address - Fax:805-884-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management