Provider Demographics
NPI:1043343502
Name:CULLINEN HAND THERAPY
Entity Type:Organization
Organization Name:CULLINEN HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLINEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:707-792-1370
Mailing Address - Street 1:7950 REDWOOD DR
Mailing Address - Street 2:SUITE 13
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-3051
Mailing Address - Country:US
Mailing Address - Phone:707-792-1370
Mailing Address - Fax:707-792-1362
Practice Address - Street 1:7950 REDWOOD DR
Practice Address - Street 2:SUITE 13
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-3051
Practice Address - Country:US
Practice Address - Phone:707-792-1370
Practice Address - Fax:707-792-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509225XH1200X, 225XR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Not Answered225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community MobilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ089082OtherBLUE SHIELD
CAZZZ089082OtherBLUE SHIELD