Provider Demographics
NPI:1043473853
Name:HULL, ANGELA CRICCHIO (DNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CRICCHIO
Last Name:HULL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MICHELLE
Other - Last Name:CRICCHIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:192 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-6913
Mailing Address - Country:US
Mailing Address - Phone:650-589-6500
Mailing Address - Fax:661-678-4534
Practice Address - Street 1:192 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-6913
Practice Address - Country:US
Practice Address - Phone:650-589-6500
Practice Address - Fax:661-678-4534
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654241363LF0000X
CA21790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily