Provider Demographics
NPI:1124196399
Name:PASSY, STANLEY (PHD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:PASSY
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:PO BOX 42133
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93140-2133
Mailing Address - Country:US
Mailing Address - Phone:805-961-2022
Mailing Address - Fax:805-565-3000
Practice Address - Street 1:212 ALSTON RD
Practice Address - Street 2:
Practice Address - City:MONTECITO
Practice Address - State:CA
Practice Address - Zip Code:93108-1805
Practice Address - Country:US
Practice Address - Phone:805-961-2022
Practice Address - Fax:805-565-3000
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12398103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical