Healthcare Provider Details

I. General information

NPI: 1285848135
Provider Name (Legal Business Name): CULLINEN HAND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 REDWOOD DR SUITE 13
COTATI CA
94931-3051
US

IV. Provider business mailing address

7950 REDWOOD DR SUITE 13
COTATI CA
94931-3051
US

V. Phone/Fax

Practice location:
  • Phone: 707-792-1370
  • Fax: 707-792-1362
Mailing address:
  • Phone: 707-792-1370
  • Fax: 707-792-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberOT 509 CA
License Number StateCA

VIII. Authorized Official

Name: SANDI CULLINEN
Title or Position: OWNER THERAPIST
Credential: OTR, CHT
Phone: 707-792-1370