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General NPI Number Information
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NPI Number | 1083152177
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Entity Type | Individual
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Provider Name | MAUDE LITTLEFIELD BLUNDELL MS
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Gender | Female
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 2801 K ST SUITE 110
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City | SACRAMENTO
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State | CA
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Zip | 95816-5120
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Country | US
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Telephone | 916-213-6036
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 PURDUE DR
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City | DAVIS
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State | CA
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Zip | 95616-1736
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Country | US
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Telephone | 530-902-1158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC000622
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License Number State | CA
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