Provider Demographics
NPI:1306051578
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA UNIV. OF CALIFORNIA HOSFORD CL
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA UNIV. OF CALIFORNIA HOSFORD CL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZETZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-893-8274
Mailing Address - Street 1:1151 EDUCATION BUILDING
Mailing Address - Street 2:UNIVERSITY OF CALIFORNIA
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-9490
Mailing Address - Country:US
Mailing Address - Phone:805-893-8064
Mailing Address - Fax:805-893-3375
Practice Address - Street 1:1151 EDUCATION BUILDING
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-9490
Practice Address - Country:US
Practice Address - Phone:805-893-8064
Practice Address - Fax:805-893-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health