Provider Demographics
NPI:1447000138
Name:PELIAS, KATHLEEN MANALO (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MANALO
Last Name:PELIAS
Suffix:
Gender:
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 HARMON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3519
Mailing Address - Country:US
Mailing Address - Phone:661-593-8358
Mailing Address - Fax:
Practice Address - Street 1:1522 STATE ST UNIT A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2514
Practice Address - Country:US
Practice Address - Phone:805-665-3835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2023125463363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner