Provider Demographics
NPI:1437288347
Name:MOCK, DENISE ALLISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ALLISON
Last Name:MOCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 DE LA VINA
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101
Mailing Address - Country:US
Mailing Address - Phone:805-845-4668
Mailing Address - Fax:833-229-2304
Practice Address - Street 1:925 DE LA VINA
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101
Practice Address - Country:US
Practice Address - Phone:805-845-4668
Practice Address - Fax:833-229-2304
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17921103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical