Provider Demographics
NPI:1497800080
Name:RAND, JUDITH A (NP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:RAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:TANGUAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 62106
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-2106
Mailing Address - Country:US
Mailing Address - Phone:805-681-1760
Mailing Address - Fax:805-681-1768
Practice Address - Street 1:317 W. PUEBLO STREET
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-1358
Practice Address - Country:US
Practice Address - Phone:805-898-3070
Practice Address - Fax:805-898-3073
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP12342CMedicare PIN