Provider Demographics
NPI:1407033301
Name:SANTA BARBARA NEIGHBORHOOD CLINICS
Entity Type:Organization
Organization Name:SANTA BARBARA NEIGHBORHOOD CLINICS
Other - Org Name:WESTSIDE NEIGHBORHOOD CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QI & COMPLIANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-617-7858
Mailing Address - Street 1:915 N MILPAS ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2331
Mailing Address - Country:US
Mailing Address - Phone:805-617-7858
Mailing Address - Fax:805-963-8880
Practice Address - Street 1:628 W MICHELTORENA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-4131
Practice Address - Country:US
Practice Address - Phone:805-963-1546
Practice Address - Fax:805-962-4771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTA BARBARA NEIGHBORHOOD CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000091261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP12002GOtherFAMILYPACT