Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY14886 | CA |
Y | 103T00000X | Psychologist | PSY14886 | CA |
NPI | 1003027145 |
---|---|
Provider Name | Dr. Shauna Kloomok |
First Address | Santa Barbara, CA 93105-3907 |
Second Address | Santa Barbara, CA 93101-2554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |