Provider Demographics
NPI:1982824306
Name:IVERSEN, JANET NOBLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:NOBLE
Last Name:IVERSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 ALAMEDA PADRE SERRA
Mailing Address - Street 2:EBBETTS HALL SUITE 211
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1756
Mailing Address - Country:US
Mailing Address - Phone:805-965-2407
Mailing Address - Fax:
Practice Address - Street 1:2020 ALAMEDA PADRE SERRA
Practice Address - Street 2:EBBETTS HALL SUITE 211
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-1756
Practice Address - Country:US
Practice Address - Phone:805-965-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15295103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPSY15295Medicare ID - Type UnspecifiedPSYCHOLOGIST