Provider Demographics
NPI:1437260312
Name:SANTA BARBARA HAND THERAPY INC
Entity Type:Organization
Organization Name:SANTA BARBARA HAND THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:RPT, CHT
Authorized Official - Phone:805-563-5333
Mailing Address - Street 1:1919 STATE ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2430
Mailing Address - Country:US
Mailing Address - Phone:805-563-5333
Mailing Address - Fax:805-563-5305
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:SUITE 208
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2430
Practice Address - Country:US
Practice Address - Phone:805-563-5333
Practice Address - Fax:805-563-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2251H1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Single Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03424ZOtherBLUE SHIELD
CAZZZ05579ZOtherBLUE SHIELD
CA4563150001Medicare NSC
CAW15763Medicare ID - Type Unspecified