Provider Demographics
NPI:1760824130
Name:BENESH, AMY MARIE (RN, PHN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:BENESH
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 OAK PARK LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4280
Mailing Address - Country:US
Mailing Address - Phone:805-563-7010
Mailing Address - Fax:
Practice Address - Street 1:2329 OAK PARK LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4280
Practice Address - Country:US
Practice Address - Phone:805-563-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA731313163WP2201X
CAPHN# 83425163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health