Provider Demographics
NPI:1467028076
Name:DR PAULINE PECK PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:DR PAULINE PECK PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:YEGHNAZAR
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-225-7374
Mailing Address - Street 1:629 STATE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-7004
Mailing Address - Country:US
Mailing Address - Phone:805-225-7374
Mailing Address - Fax:
Practice Address - Street 1:629 STATE ST STE 205
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-7004
Practice Address - Country:US
Practice Address - Phone:805-225-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty