Provider Demographics
NPI:1093867269
Name:FELICIANO, EDWIN AMERICO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:AMERICO
Last Name:FELICIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:UCSB STUDENT HEALTH M/C 7002
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-0001
Mailing Address - Country:US
Mailing Address - Phone:805-893-3088
Mailing Address - Fax:805-893-4911
Practice Address - Street 1:552 UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-3814
Practice Address - Country:US
Practice Address - Phone:805-893-3088
Practice Address - Fax:805-893-4911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC517642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry