MEDICARE: AVYONNE TARIA CURRINGTON SUDRC-II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1639020340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVYONNE TARIA CURRINGTON SUDRC-II

Provider Business Mailing Address
First Line	:	3109 SCHOOL ST
Second Line	:
City	:	FORTUNA
State	:	CA
Zip	:	95540-3601
Country	:	US
Telephone Number	:	707-496-9391
Fax Number	:

Provider Business Practice Location Address
First Line	:	2141 TYDD ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-5626
Country	:	US
Telephone Number	:	707-445-3141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2026
Last Update Date	:	02/09/2026

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