Provider Demographics
NPI:1194081323
Name:BREGANTE, JAIME LYNN
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:LYNN
Last Name:BREGANTE
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 1:844 LA MILPITA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2531
Mailing Address - Country:US
Mailing Address - Phone:805-448-4021
Mailing Address - Fax:
Practice Address - Street 1:123 W PADRE ST STE E2
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3960
Practice Address - Country:US
Practice Address - Phone:805-724-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97318101YM0800X
101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health