Provider Demographics
NPI:1710321500
Name:PATEL-ROSS, SAPNA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:M
Last Name:PATEL-ROSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3836
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-3836
Mailing Address - Country:US
Mailing Address - Phone:714-915-2053
Mailing Address - Fax:844-673-6166
Practice Address - Street 1:5266 HOLLISTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-4038
Practice Address - Country:US
Practice Address - Phone:714-915-2053
Practice Address - Fax:805-884-8343
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25447103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB236181Medicare PIN