Individual
CRISTINA MARIE THUDIUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42485 ROUNDUP DR, AGUANGA, CA 92536-9340
(951) 707-8945
Mailing address
42485 ROUNDUP DR, AGUANGA, CA 92536-9340
(951) 707-8945
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4827242
DRIVER LICENSE
CA
Enumeration date
10/28/2019
Last updated
10/28/2019
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