Provider Demographics
NPI:1346366028
Name:CURTIS, EULA MARIE
Entity Type:Individual
Prefix:MRS
First Name:EULA
Middle Name:MARIE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 MARSTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95605-2205
Mailing Address - Country:US
Mailing Address - Phone:916-371-9317
Mailing Address - Fax:916-371-2662
Practice Address - Street 1:1108 MARSTON ST
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95605-2205
Practice Address - Country:US
Practice Address - Phone:916-371-9317
Practice Address - Fax:916-371-2662
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home