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General NPI Number Information
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NPI Number | 1558277749
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Entity Type | Individual
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Provider Name | ANNALISA CUNNINGHAM
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 3775 BODEGA AVE
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City | PETALUMA
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State | CA
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Zip | 94952-8037
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Country | US
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Telephone | 707-765-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 ELIZABETH CT
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City | SEBASTOPOL
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State | CA
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Zip | 95472-2001
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Country | US
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Telephone | 707-765-4345
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 0F0B30ED4B
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License Number State | CA
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