Provider Demographics
NPI:1619576402
Name:PULLIN, DANIELLE LORRAINE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LORRAINE
Last Name:PULLIN
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 1:891 MOUNTAIN RANCH ROAD
Mailing Address - Street 2:BEHAVIORAL HEALTH DEPARTMENT
Mailing Address - City:SAN ANDREAS
Mailing Address - State:CA
Mailing Address - Zip Code:95249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:891 MOUNTAIN RANCH ROAD
Practice Address - Street 2:BEHAVIORAL HEALTH DEPARTMENT
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-754-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator