Provider Demographics
NPI:1013752112
Name:PUTNAM, KALEB SEBASTIAN I
Entity type:Individual
Prefix:
First Name:KALEB
Middle Name:SEBASTIAN
Last Name:PUTNAM
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 JAY ST
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1523
Mailing Address - Country:US
Mailing Address - Phone:805-680-7340
Mailing Address - Fax:
Practice Address - Street 1:1524 JAY ST
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1523
Practice Address - Country:US
Practice Address - Phone:805-680-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program