Provider Demographics
NPI:1891279147
Name:HERBERT, ALISSA ANN (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:ANN
Last Name:HERBERT
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 E MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1028
Mailing Address - Country:US
Mailing Address - Phone:805-895-8753
Mailing Address - Fax:
Practice Address - Street 1:2958 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3418
Practice Address - Country:US
Practice Address - Phone:805-770-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-22
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM541176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife