Provider Demographics
NPI:1942389457
Name:VERICA, THOMAS ALOYSIUS (MFT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALOYSIUS
Last Name:VERICA
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 MARICOPA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1414
Mailing Address - Country:US
Mailing Address - Phone:805-898-1424
Mailing Address - Fax:
Practice Address - Street 1:429 N SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1399
Practice Address - Country:US
Practice Address - Phone:805-884-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46345106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist