Provider Demographics
NPI:1477851681
Name:BROOKS, RONALD BRIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:BRIAN
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:BRIAN
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1335 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2609
Mailing Address - Country:US
Mailing Address - Phone:805-962-0266
Mailing Address - Fax:805-898-9610
Practice Address - Street 1:629 STATE ST
Practice Address - Street 2:STE 203
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-7071
Practice Address - Country:US
Practice Address - Phone:805-962-0266
Practice Address - Fax:805-898-9610
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8974103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical