Individual
GLENN PETILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
00270053
CA
376K00000X
Nurse's Aide
Primary
00903914
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00270053
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH HOME HEALTH AIDE
CA
01
—
00903914
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH CERTIFIED NURSING ASSISTANT
CA
Enumeration date
07/15/2016
Last updated
07/15/2016
Update your record
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