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General NPI Number Information
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NPI Number | 1417450149
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Entity Type | Individual
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Provider Name | IRIS DICHUPA
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Gender | Female
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 75 NIELSON ST
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City | WATSONVILLE
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State | CA
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Zip | 95076-2468
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Country | US
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Telephone | 831-724-4741
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Fax |
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Provider Business Mailing Address
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Address Line | 2041 EAST ST STE 1377
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City | CONCORD
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State | CA
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Zip | 94520-2126
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Country | US
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Telephone | 831-244-0111
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95000885
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License Number State | CA
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