Healthcare Provider Details
I. General information
NPI: 1225770993
Provider Name (Legal Business Name): KARRINE MEI CUATOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2141 PALOMAR AIRPORT RD STE 350
CARLSBAD CA
92011-1451
US
IV. Provider business mailing address
7571 CORELLI LN
SAN DIEGO CA
92127-3844
US
V. Phone/Fax
- Phone: 760-438-0078
- Fax:
- Phone: 858-692-4331
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: