Healthcare Provider Details

I. General information

NPI: 1700398559
Provider Name (Legal Business Name): MARIA CUCICEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 11/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8734 SOTHEBY CT
FAIR OAKS CA
95628-5468
US

IV. Provider business mailing address

8734 SOTHEBY CT
FAIR OAKS CA
95628-5468
US

V. Phone/Fax

Practice location:
  • Phone: 916-534-7608
  • Fax: 916-534-7609
Mailing address:
  • Phone: 916-534-7608
  • Fax: 916-534-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: