Provider Demographics
NPI:1104063890
Name:BUENIK, TAMI L (MA)
Entity type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:L
Last Name:BUENIK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W ARRELLAGA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2903
Mailing Address - Country:US
Mailing Address - Phone:805-962-2963
Mailing Address - Fax:805-962-2965
Practice Address - Street 1:118 W ARRELLAGA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2903
Practice Address - Country:US
Practice Address - Phone:805-962-2963
Practice Address - Fax:805-962-2965
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000009134OtherUPIN