Provider Demographics
NPI:1609107127
Name:PONS, ANDREA ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:PONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CASTILLO ST
Mailing Address - Street 2:APT. #15
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3843
Mailing Address - Country:US
Mailing Address - Phone:925-980-6734
Mailing Address - Fax:805-965-3797
Practice Address - Street 1:107 E MICHELTORENA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1905
Practice Address - Country:US
Practice Address - Phone:805-965-6786
Practice Address - Fax:805-965-3797
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health