Healthcare Provider Details

I. General information

NPI: 1407922073
Provider Name (Legal Business Name): OLGA MYKOLAIVNA KUZENNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 CALLE REAL CASA DEL MURAL
SANTA BARBARA CA
93110-1306
US

IV. Provider business mailing address

66 OCEAN VIEW AVE APARTMENT 14
SANTA BARBARA CA
93103-2975
US

V. Phone/Fax

Practice location:
  • Phone: 805-692-4066
  • Fax:
Mailing address:
  • Phone: 805-698-2628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: