Provider Demographics
NPI:1437179660
Name:MCCURDY, CASSANDRA JUNE (MSN,NP-C)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JUNE
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:MSN,NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 NORMAN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-5900
Mailing Address - Country:US
Mailing Address - Phone:209-825-6331
Mailing Address - Fax:209-825-6351
Practice Address - Street 1:1140 NORMAN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5900
Practice Address - Country:US
Practice Address - Phone:209-825-6331
Practice Address - Fax:209-825-6351
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP16223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP16223OtherSTATE LICENSE