Provider Demographics
NPI:1326477118
Name:DESILVA, MICASHA
Entity Type:Individual
Prefix:
First Name:MICASHA
Middle Name:
Last Name:DESILVA
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 1:402 E CARRILLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1449
Mailing Address - Country:US
Mailing Address - Phone:805-963-8156
Mailing Address - Fax:805-564-8025
Practice Address - Street 1:315 W CARRILLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6904
Practice Address - Country:US
Practice Address - Phone:805-963-8156
Practice Address - Fax:805-564-8025
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health