Provider Demographics
NPI:1205195898
Name:WHEELER, TRISTINE CENORA
Entity type:Individual
Prefix:
First Name:TRISTINE
Middle Name:CENORA
Last Name:WHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRISTINE
Other - Middle Name:CENORA
Other - Last Name:BRUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-0551
Mailing Address - Country:US
Mailing Address - Phone:805-569-2785
Mailing Address - Fax:805-563-1977
Practice Address - Street 1:222 W VALERIO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2930
Practice Address - Country:US
Practice Address - Phone:805-569-2785
Practice Address - Fax:805-563-1977
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health