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General NPI Number Information
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NPI Number | 1619568037
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Entity Type | Individual
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Provider Name | PAULINA PIECH ATC
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 1270 S 7TH ST.
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City | SAN JOSE
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State | CA
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Zip | 95112-5909
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Country | US
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Telephone | 773-964-2625
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Fax |
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Provider Business Mailing Address
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Address Line | 5027 S VENTURA CT
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City | AURORA
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State | CO
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Zip | 80015-2051
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Country | US
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Telephone | 773-964-2625
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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 | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | Q190029
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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