Individual
ANDREA F ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 CARMEN LN STE A, SANTA MARIA, CA 93458-7768
(805) 348-1850
Mailing address
124 CARMEN LN STE A, SANTA MARIA, CA 93458-7768
(805) 348-1850
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689762486
MCMILLAN RANCH
—
Enumeration date
01/29/2019
Last updated
01/29/2019
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