Provider Demographics
NPI:1184025272
Name:VOOS, AVERY
Entity Type:Individual
Prefix:
First Name:AVERY
Middle Name:
Last Name:VOOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 DE LA VINA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3202
Mailing Address - Country:US
Mailing Address - Phone:805-530-5252
Mailing Address - Fax:
Practice Address - Street 1:925 DE LA VINA ST STE 100
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3202
Practice Address - Country:US
Practice Address - Phone:805-530-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30702103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty