Provider Demographics
NPI:1669722674
Name:PEERBUDDIES
Entity type:Organization
Organization Name:PEERBUDDIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHRESTANI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:805-620-7337
Mailing Address - Street 1:3463 STATE ST
Mailing Address - Street 2:275
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2662
Mailing Address - Country:US
Mailing Address - Phone:805-620-7337
Mailing Address - Fax:
Practice Address - Street 1:3463 STATE ST
Practice Address - Street 2:275
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-2662
Practice Address - Country:US
Practice Address - Phone:805-620-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health