Organization
SANTA BARBARA NEIGHBORHOOD CLINICS
Active
Parent organization
SANTA BARBARA NEIGHBORHOOD CLINICS
Other names
Westside Neighborhood Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANTA BARBARA NEIGHBORHOOD CLINICS
Authorized official
DR. CHARLES CAMILLO FENZI M.D. (CHIEF EXECUTIVE OFFICER)
(805) 617-7850
Entity
Organization
Contact information
Practice address
628 W MICHELTORENA ST, SANTA BARBARA, CA 93101-4131
(805) 963-1546
(805) 962-4771
Mailing address
915 N MILPAS ST, 2ND FLOOR, SANTA BARBARA, CA 93103-2331
(805) 617-7858
(805) 963-8880
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
050000091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0584453
CLIA
CA
01
—
1407033301
FAMPACT NPI
CA
01
—
1598942492
CPD NPI
CA
01
—
168902
CCS
CA
01
—
BCP12002G
CDP
CA
01
—
CLN 1074
BOARD OF PHARMACY CLINIC PERMIT
CA
01
—
CLP 303897
DHS LAB REGISTRATION NUMBER
CA
01
—
FHC12002G
CHDP
—
05
—
FHC12002G
—
CA
01
—
HAP12002G
FP
CA
Enumeration date
07/14/2006
Last updated
03/03/2016
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