Provider Demographics
NPI:1962736769
Name:PFAFF, TARA PATRICE (MS, PPS)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:PATRICE
Last Name:PFAFF
Suffix:
Gender:F
Credentials:MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WILLOW SPRINGS LN APT 202
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-3195
Mailing Address - Country:US
Mailing Address - Phone:805-967-4581
Mailing Address - Fax:805-967-8358
Practice Address - Street 1:4750 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1921
Practice Address - Country:US
Practice Address - Phone:805-967-4581
Practice Address - Fax:805-967-8358
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)