Provider Demographics
NPI:1164891297
Name:BIENUSA, WEDNESDAY (ATC)
Entity Type:Individual
Prefix:
First Name:WEDNESDAY
Middle Name:
Last Name:BIENUSA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 SYLVAN DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2108
Mailing Address - Country:US
Mailing Address - Phone:530-417-4481
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF INTERCOLLEGIATE ATHLETICS
Practice Address - Street 2:UC SANTA BARBARA, ICA BUILDING
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-5200
Practice Address - Country:US
Practice Address - Phone:805-319-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer