Healthcare Provider Details

I. General information

NPI: 1346549599
Provider Name (Legal Business Name): JULIA CUCINELLA RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2011
Last Update Date: 03/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 13TH ST
PASO ROBLES CA
93446-2226
US

IV. Provider business mailing address

503 13TH ST
PASO ROBLES CA
93446-2226
US

V. Phone/Fax

Practice location:
  • Phone: 805-440-6676
  • Fax:
Mailing address:
  • Phone: 805-440-6676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: