MEDICARE: DAVINA CUELLAR

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1932514015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVINA CUELLAR

Provider Business Mailing Address
First Line	:	3800 WATT AVE STE 110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2622
Country	:	US
Telephone Number	:	916-904-4687
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 WATT AVE STE 110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2622
Country	:	US
Telephone Number	:	916-584-7800
Fax Number	:

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

Provider Enumeration Date	:	06/26/2014
Last Update Date	:	05/05/2021

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Directions to “ DAVINA CUELLAR ” Practice Location

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