Healthcare Provider Details

I. General information

NPI: 1730699729
Provider Name (Legal Business Name): AMY CUTINO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 A ST
HAYWARD CA
94541-4106
US

IV. Provider business mailing address

1691 THE ALAMEDA
SAN JOSE CA
95126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 510-300-3800
  • Fax: 510-300-8039
Mailing address:
  • Phone: 408-795-3619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95007791
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95125505
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: