Provider Demographics
NPI:1558710186
Name:DIAZ-EBADI, SONIA CRISTINA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:CRISTINA
Last Name:DIAZ-EBADI
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E VICTORIA ST STE L
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-8741
Mailing Address - Country:US
Mailing Address - Phone:805-637-7630
Mailing Address - Fax:
Practice Address - Street 1:27 E VICTORIA ST STE L
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-8741
Practice Address - Country:US
Practice Address - Phone:805-637-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-04
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95951106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist