Healthcare Provider Details

I. General information

NPI: 1649002767
Provider Name (Legal Business Name): MARCI A WULFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 AUBURN BLVD STE 100
SACRAMENTO CA
95821-2124
US

IV. Provider business mailing address

1 SAN GREGORIO CT
SACRAMENTO CA
95834-7636
US

V. Phone/Fax

Practice location:
  • Phone: 916-238-8227
  • Fax:
Mailing address:
  • Phone: 808-283-8468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: