Provider Demographics
NPI:1184914020
Name:TRAUBE, MATT
Entity type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:TRAUBE
Suffix:
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 1:3711 HITCHCOCK RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3177
Mailing Address - Country:US
Mailing Address - Phone:781-223-8629
Mailing Address - Fax:
Practice Address - Street 1:3711 HITCHCOCK RANCH RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3177
Practice Address - Country:US
Practice Address - Phone:781-223-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84815106H00000X
MALMFT1545106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherSSN