Provider Demographics
NPI:1679587224
Name:GOLETA VALLEY COTTAGE HOSPITAL
Entity Type:Organization
Organization Name:GOLETA VALLEY COTTAGE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TUFVESSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-879-8941
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:C/O FINANCE DEPARTMENT
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-0689
Mailing Address - Country:US
Mailing Address - Phone:805-879-8964
Mailing Address - Fax:805-879-8945
Practice Address - Street 1:351 S PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-2403
Practice Address - Country:US
Practice Address - Phone:805-967-3411
Practice Address - Fax:805-681-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000034314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55617FMedicaid
CALTC70106FMedicaid
CA555617Medicare Oscar/Certification