MR. MAX KYLE HAGEN-OLSEN (NPI# 1972093623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972093623 |
| Entity Type | Individual |
| Full Name | MR. MAX KYLE HAGEN-OLSEN |
| Credential | CNA |
| Practice Address |
66 S San Antonio Rd Santa Barbara CA 93110 |
| Mailing Address |
29 Dearborn Pl Apt 23 Goleta CA 93117-3535 |
| Practice Telephone | 8059475175 |
| Practice Fax Number | 8059673510 |
| Mailing Telephone | 8054531750 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-06-07 |
| NPI Deactivation Date | 05/19/2018 |
| NPI Reactivation Date | 2018-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 376K00000X | Nurse's Aide | 00991675 | CA | Nursing Service Related Providers |
| Street Address |
66 S SAN ANTONIO RD |
| City | SANTA BARBARA |
| State | CA |
| Zip Code | 93110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336207257 | Heidi Ann Hanson | Marriage & Family Therapist | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2006-12-04 |
| 1851908784 | Caressa Eve Suarez | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-09-24 |
| 1487268066 | Dana Franz | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-09-01 |
| 1386257582 | Amanda Drogemuller | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-08-26 |
| 1750994158 | Luisa Fernanda Castillo Sarria | Licensed Vocational Nurse | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-08-25 |
| 1255943130 | Madison Feenstra | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-08-20 |
| 1821600446 | Rianna Ramos | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-08-17 |
| 1225648918 | Angel F Diaz | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-08-06 |
| 1801412507 | Kalia Marie Rothlind | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-06-18 |
| 1366066912 | Bretta Marie Bradbury | Rehabilitation Practitioner | 66 S San Antonio Rd, Santa Barbara, CA 93110-1720 | 2020-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386287431 | Rosanne M. Marquis | Technician | 4131 Creviente Drive, Santa Barbara, CA 93110 | 2019-10-22 |
| 1467961722 | Chris Latham | Nutritionist | 4760 Amarosa Street, Santa Barbara, CA 93110 | 2017-09-29 |
| 1770030330 | Laurence Seguin-brault | Social Worker | 66 South Anttonio Road, Santa Barbara, CA 93110 | 2016-09-01 |
| 1891142626 | Patricia Hurtado | Peer Specialist | 66 S San Antonio Road, Santa Barbara, CA 93110 | 2016-05-23 |
| 1023494945 | Santa Barbara County Alcogol, Drug & Mental Health Services | Social Worker | 66 S. San Antonio Road, Santa Barbara, CA 93110 | 2015-08-03 |
| 1225382088 | Terry Gostow | Speech-Language Pathologist | 333 Old Mill Road, #314, Santa Barbara, CA 93110 | 2012-11-01 |
| 1184914020 | Matt Traube | Marriage & Family Therapist | 3953 Carol Ave, Santa Barbara, CA 93110 | 2011-04-12 |
| 1679715270 | Abundant Care IIi | Assisted Living Facility | 4589 Anhay Dr, Santa Barbara, CA 93110 | 2009-03-27 |
| 1508052333 | Chadler R Burgoyne | Orthopaedic Surgery | Sansum Orthopedic Clinic, 4151 Foothill Rd - Bldg A, Santa Barbara, CA 93110 | 2007-09-14 |
| 1689878894 | Jill Louise Daugherty | Counselor | Admhs, Santa Barbara, CA 93110 | 2007-06-12 |
| Find all providers in zip 93110 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943652 | Petra Beumer | Counselor | 697 Circle Dr, Santa Barbara, CA 93108-1001 | 2020-05-07 |
| 1124654249 | Kaylie Reynolds | Counselor | 301 W Figueroa St, Santa Barbara, CA 93101-3632 | 2020-03-20 |
| 1710436001 | Jordan Ko | Counselor | 430 Ribera Dr, Santa Barbara, CA 93111-1804 | 2016-09-27 |
| 1811395569 | Sierra Rose Smargon | Counselor | 629 State St Ste 243, Santa Barbara, CA 93101-7074 | 2014-12-11 |
| 1720392350 | David Botsford | Counselor | 835 Alberta Ave, Santa Barbara, CA 93101-4701 | 2010-08-06 |
| 1194056747 | Jennifer Lynne Strube | Counselor | 25 West Anapama St, Cada, Santa Barbara, CA 93101-5148 | 2010-01-21 |
| 1497935613 | Laurie Christine Punches | Counselor | 201 Los Alamos Ave, Santa Barbara, CA 93109-2031 | 2007-11-05 |
| 1861686537 | Dale Schuck | Counselor | 1020 Placido Ave, Santa Barbara, CA 93103-3254 | 2007-09-05 |
| 1851584072 | Amy Lovelace | Counselor | 721 E Cota St, Santa Barbara, CA 93103-3184 | 2007-08-21 |
| 1689878894 | Jill Louise Daugherty | Counselor | Admhs, Santa Barbara, CA 93110 | 2007-06-12 |
| Find all providers in SANTA BARBARA | ||||
| City | SANTA BARBARA |
| Zip Code | 93110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.