Provider Demographics
NPI:1114592888
Name:MARCELINO, ANNE H (LICENSE PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:H
Last Name:MARCELINO
Suffix:
Gender:F
Credentials:LICENSE PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1858
Mailing Address - Country:US
Mailing Address - Phone:805-701-9787
Mailing Address - Fax:
Practice Address - Street 1:185 ROSEWOOD ST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1858
Practice Address - Country:US
Practice Address - Phone:805-701-9787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00065875246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty