Provider Demographics
NPI:1164578670
Name:CASIANO, TAMMY LYNN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LYNN
Last Name:CASIANO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 HOLLISTER AVE # 14
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2389
Mailing Address - Country:US
Mailing Address - Phone:805-884-1673
Mailing Address - Fax:
Practice Address - Street 1:5385 HOLLISTER AVE # 14
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-2389
Practice Address - Country:US
Practice Address - Phone:805-884-1673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAWAIVEREDPSYCHOLOGIST103TC0700X
CAMFCC 48694106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1770665887Medicare UPIN