Provider Demographics
NPI:1134246168
Name:FOSTER, LAEL ELIZABETH (PHD)
Entity type:Individual
Prefix:
First Name:LAEL
Middle Name:ELIZABETH
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MICHELTORENA ST
Mailing Address - Street 2:STE C
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6524
Mailing Address - Country:US
Mailing Address - Phone:805-403-0265
Mailing Address - Fax:
Practice Address - Street 1:22 W MICHELTORENA ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6522
Practice Address - Country:US
Practice Address - Phone:805-564-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist