Provider Demographics
NPI:1629417670
Name:CASPARRO, DINA NICOLE (DPM)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:NICOLE
Last Name:CASPARRO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 DUFFIN DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6600
Mailing Address - Country:US
Mailing Address - Phone:805-428-0773
Mailing Address - Fax:831-531-2507
Practice Address - Street 1:581 MCCRAY ST STE F
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023
Practice Address - Country:US
Practice Address - Phone:831-636-3338
Practice Address - Fax:831-531-2507
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5239213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery