Provider Demographics
NPI:1881773174
Name:PRIMEAU, CAROL (PHD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:PRIMEAU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5662 CALLE REAL # 111
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2317
Mailing Address - Country:US
Mailing Address - Phone:805-682-8875
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:484 ARANGO DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-1901
Practice Address - Country:US
Practice Address - Phone:805-680-3612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8659103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical