Provider Demographics
NPI:1265625826
Name:ZOELLNER, MARLENE (MA,MFT)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:ZOELLNER
Suffix:
Gender:F
Credentials:MA,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 CALLE BOCA DEL CANON
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-4903
Mailing Address - Country:US
Mailing Address - Phone:805-962-6842
Mailing Address - Fax:
Practice Address - Street 1:1708 CALLE BOCA DEL CANON
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-4903
Practice Address - Country:US
Practice Address - Phone:805-962-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC13034101YM0800X
CAMFT13034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health