Provider Demographics
NPI:1598950628
Name:SANTA BARBARA ACUPUNCTURE ASSOCIATES
Entity Type:Organization
Organization Name:SANTA BARBARA ACUPUNCTURE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:LISLE
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:805-570-0109
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-0028
Mailing Address - Country:US
Mailing Address - Phone:805-564-6057
Mailing Address - Fax:805-963-8849
Practice Address - Street 1:133 E HALEY ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2330
Practice Address - Country:US
Practice Address - Phone:805-564-6057
Practice Address - Fax:805-963-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7105171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty