Provider Demographics
NPI:1760630370
Name:CAPRISTO, DEISE PONCE (LCSW)
Entity Type:Individual
Prefix:
First Name:DEISE
Middle Name:PONCE
Last Name:CAPRISTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N MILPAS ST
Mailing Address - Street 2:FL 2
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2331
Mailing Address - Country:US
Mailing Address - Phone:805-965-2376
Mailing Address - Fax:805-963-6707
Practice Address - Street 1:1236 CHAPALA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3116
Practice Address - Country:US
Practice Address - Phone:805-965-2376
Practice Address - Fax:805-963-6707
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA650651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical