Provider Demographics
NPI:1295002434
Name:SANTA YNEZ BAND OF MISSION INDIANS
Entity Type:Organization
Organization Name:SANTA YNEZ BAND OF MISSION INDIANS
Other - Org Name:SANTA YNEZ BAND OF MISSION INDIANS DBA SANTA YNEZ TRIBAL HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-688-7070
Mailing Address - Street 1:PO BOX 539
Mailing Address - Street 2:
Mailing Address - City:SANTA YNEZ
Mailing Address - State:CA
Mailing Address - Zip Code:93460
Mailing Address - Country:US
Mailing Address - Phone:805-688-7070
Mailing Address - Fax:805-686-2060
Practice Address - Street 1:680 ALAMO PINTADO STE 202
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463
Practice Address - Country:US
Practice Address - Phone:805-688-7070
Practice Address - Fax:805-686-2060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTA YNEZ BANK OF CHUMASH INDIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-16
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health