Provider Demographics
NPI:1669873048
Name:LOOMIS, MORENA (RN, PHN, BSN)
Entity type:Individual
Prefix:
First Name:MORENA
Middle Name:
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:RN, PHN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 CAMINO DEL REMEDIO
Mailing Address - Street 2:3RD FLOOR, BUILDING 4
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1332
Mailing Address - Country:US
Mailing Address - Phone:805-681-5468
Mailing Address - Fax:805-681-4915
Practice Address - Street 1:345 CAMINO DEL REMEDIO
Practice Address - Street 2:3RD FLOOR, BUILDING 4
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1332
Practice Address - Country:US
Practice Address - Phone:805-681-5468
Practice Address - Fax:805-681-4915
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95038120163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health