Provider Demographics
NPI:1669284501
Name:SUBRAMANIAN, PREMI (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:PREMI
Middle Name:
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:PUVANASPRI
Other - Middle Name:
Other - Last Name:SUBRAMANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:228 UHLAN CT
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2913
Mailing Address - Country:US
Mailing Address - Phone:805-679-1549
Mailing Address - Fax:
Practice Address - Street 1:228 UHLAN CT
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2913
Practice Address - Country:US
Practice Address - Phone:805-679-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123649103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy