Provider Demographics
NPI:1578662680
Name:SANTA BARBARA COUNTY PUBLIC HEALTH DEPT
Entity Type:Organization
Organization Name:SANTA BARBARA COUNTY PUBLIC HEALTH DEPT
Other - Org Name:CALIFORNIA CHILDREN'S SERVICES LOMPOC PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASEHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:805-681-5133
Mailing Address - Street 1:1111 CHAPALA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3100
Mailing Address - Country:US
Mailing Address - Phone:805-681-5133
Mailing Address - Fax:805-681-4763
Practice Address - Street 1:1 MOUNTAIN VIEW BLVD
Practice Address - Street 2:LOS PADRES SCHOOL
Practice Address - City:VANDENBERG AIR FORCE BASE
Practice Address - State:CA
Practice Address - Zip Code:93437
Practice Address - Country:US
Practice Address - Phone:805-734-2005
Practice Address - Fax:805-734-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00073FMedicaid