Provider Demographics
NPI:1265471528
Name:DEAN, JUDY CATHRYN
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:CATHRYN
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:CATHRYN
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1525 STATE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6510
Mailing Address - Country:US
Mailing Address - Phone:805-560-8111
Mailing Address - Fax:
Practice Address - Street 1:1711 E VALLEY RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2106
Practice Address - Country:US
Practice Address - Phone:805-565-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44016174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG44016OtherMEDICARE ID
CAG44016OtherMEDICARE ID