Basic Information
| Provider Information | |||||||||
| NPI: | 1942493283 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANFILIPPO | ||||||||
| FirstName: | INGRID | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51943 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930311943 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4129 STATE ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059644795 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 08/21/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | IMF 50252 | CA | Y | Behavioral Health & Social Service Providers | Counselor | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.