Provider Demographics
NPI:1538203039
Name:LATHAM, ELIZABETH LESLIE (MFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LESLIE
Last Name:LATHAM
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ALTA VISTA RD
Mailing Address - Street 2:APT 310
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2369
Mailing Address - Country:US
Mailing Address - Phone:805-962-9609
Mailing Address - Fax:
Practice Address - Street 1:25 W ANAPAMU ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5148
Practice Address - Country:US
Practice Address - Phone:805-730-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)