Active NPI
Sara Bukacek Bazan
- Marriage & Family Therapist
- Santa Barbara, CA
National Provider Identifier
1174696405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 47105
- Practice address
- 822 E Canon Perdido St Unit 2
Santa Barbara, CA 93103-3059 - Phone
- (805) 403-0270
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 47105 | CA | Primary |
Addresses
Primary practice location
822 E Canon Perdido St Unit 2
Santa Barbara, CA 93103-3059
Mailing address
822 E Canon Perdido St Unit 2
Santa Barbara, CA 93103-3059
Phone (805) 403-0270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3869 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47105 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1174696405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 E CANON PERDIDO ST UNIT 2",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931033059",
"telephone_number": "805-403-0270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 E CANON PERDIDO ST UNIT 2",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931033059",
"telephone_number": "805-403-0270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZAN",
"first_name": "SARA",
"middle_name": "BUKACEK",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "47105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3869",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.