Provider Demographics
NPI:1316157662
Name:BUSH, SYDNEY WRAY (RN, CDE)
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:WRAY
Last Name:BUSH
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 BORTON DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1838
Mailing Address - Country:US
Mailing Address - Phone:805-637-7941
Mailing Address - Fax:805-966-7941
Practice Address - Street 1:2444 BORTON DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1838
Practice Address - Country:US
Practice Address - Phone:805-637-7941
Practice Address - Fax:805-966-7941
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA266635163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator