Provider Demographics
NPI:1346381860
Name:CUDDY, UTA RENATE SCHEIBER (LAC, DNBAO)
Entity Type:Individual
Prefix:MRS
First Name:UTA
Middle Name:RENATE SCHEIBER
Last Name:CUDDY
Suffix:
Gender:F
Credentials:LAC, DNBAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-7011
Mailing Address - Country:US
Mailing Address - Phone:858-277-4051
Mailing Address - Fax:
Practice Address - Street 1:411 THORN ST
Practice Address - Street 2:SUITE A 2
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5700
Practice Address - Country:US
Practice Address - Phone:619-295-8945
Practice Address - Fax:619-295-8998
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7167171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist