Individual
ALICE CUCCUINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
801 E ST, PATTERSON, CA 95363-2670
(209) 892-2081
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA126650
—
CA
Enumeration date
05/04/2006
Last updated
05/28/2010
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