Provider Demographics
NPI:1316133846
Name:CONTRERAS, SUYAPA WALESCA
Entity type:Individual
Prefix:MISS
First Name:SUYAPA
Middle Name:WALESCA
Last Name:CONTRERAS
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 1:29 DEARBORN PL APT 4
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-3538
Mailing Address - Country:US
Mailing Address - Phone:805-708-5756
Mailing Address - Fax:
Practice Address - Street 1:2950 STATE ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3464
Practice Address - Country:US
Practice Address - Phone:805-898-1018
Practice Address - Fax:805-898-1056
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)