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General NPI Number Information
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NPI Number | 1093708901
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Entity Type | Individual
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Provider Name | STEPHANIE G CULLINANE PA C
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Gender | Female
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 2330 MARINSHIP WAY STE 370
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City | SAUSALITO
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State | CA
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Zip | 94965-2853
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Country | US
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Telephone | 415-887-9758
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Fax | 415-887-9763
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Provider Business Mailing Address
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Address Line | 535 MILLER AVE
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City | MILL VALLEY
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State | CA
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Zip | 94941-2905
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Country | US
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Telephone | 415-383-5486
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Fax | 415-389-7455
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA15353
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License Number State | CA
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