Provider Demographics
NPI:1497121875
Name:MARIPOSAS PROJECT
Entity Type:Organization
Organization Name:MARIPOSAS PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASJUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:805-689-1104
Mailing Address - Street 1:5649 W CAMINO CIELO
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-9706
Mailing Address - Country:US
Mailing Address - Phone:805-823-4500
Mailing Address - Fax:
Practice Address - Street 1:317 LOMA VISTA AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1212
Practice Address - Country:US
Practice Address - Phone:805-824-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency