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General NPI Number Information
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NPI Number | 1376405365
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Entity Type | Individual
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Provider Name | CARRIE A NIELSEN CPT, PT ASCP
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Gender | Female
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 97 DOBBINS ST STE C
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City | VACAVILLE
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State | CA
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Zip | 95688-2700
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Country | US
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Telephone | 707-301-8118
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Fax |
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Provider Business Mailing Address
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Address Line | 137 MAPLE ST
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City | VACAVILLE
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State | CA
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Zip | 95688-6941
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Country | US
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Telephone | 707-301-8118
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | CPT-00020316
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License Number State | CA
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