Provider Demographics
NPI:1528471216
Name:HAGARMAN, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HAGARMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E COTA ST FL 1
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1624
Mailing Address - Country:US
Mailing Address - Phone:805-617-7878
Mailing Address - Fax:805-617-7880
Practice Address - Street 1:5580 CALLE REAL
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-1646
Practice Address - Country:US
Practice Address - Phone:805-617-7878
Practice Address - Fax:805-617-7880
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1010631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical