Provider Demographics
NPI:1851417232
Name:PULNIK, HELENE ANN (ND)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:ANN
Last Name:PULNIK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24941 DANA POINT HARBOR DR # C120
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2918
Mailing Address - Country:US
Mailing Address - Phone:949-416-4670
Mailing Address - Fax:949-497-1144
Practice Address - Street 1:24941 DANA POINT HARBOR DR # C120
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2918
Practice Address - Country:US
Practice Address - Phone:949-416-4670
Practice Address - Fax:949-238-7596
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000235175F00000X
CANDF636175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT529871OtherCONNECTICARE PROVIDER ID
CT110000235CT01OtherBLUE CROSS PROVIDER ID