Provider Demographics
NPI:1962970996
Name:CENTRAL COAST EATING DISORDER PROGRAM SERVICES AND WORKSHOP
Entity type:Organization
Organization Name:CENTRAL COAST EATING DISORDER PROGRAM SERVICES AND WORKSHOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER-UYEHARA
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE, NHA, RHIA
Authorized Official - Phone:808-966-7453
Mailing Address - Street 1:16-643 KIPIMANA ST STE 20
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-8002
Mailing Address - Country:US
Mailing Address - Phone:808-966-7453
Mailing Address - Fax:
Practice Address - Street 1:16 W MISSION ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2426
Practice Address - Country:US
Practice Address - Phone:808-966-7453
Practice Address - Fax:808-966-8990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL COAST EATING DISORDER PROGRAM SERVICES AND WORKSHOP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty