Provider Demographics
NPI:1831697606
Name:FAULKNER, CARRIE NICOLE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:NICOLE
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1664
Mailing Address - Country:US
Mailing Address - Phone:805-884-8440
Mailing Address - Fax:805-884-8445
Practice Address - Street 1:617 GARDEN ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1664
Practice Address - Country:US
Practice Address - Phone:805-884-8440
Practice Address - Fax:805-884-8445
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health