Provider Demographics
NPI:1124058565
Name:MARCELINE, TOSI (LM, CPM)
Entity type:Individual
Prefix:MS
First Name:TOSI
Middle Name:
Last Name:MARCELINE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26990 ROAD 95A
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-9443
Mailing Address - Country:US
Mailing Address - Phone:530-756-8202
Mailing Address - Fax:539-753-6142
Practice Address - Street 1:26990 COUNTY ROAD 95A
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-9443
Practice Address - Country:US
Practice Address - Phone:530-756-8202
Practice Address - Fax:539-753-6142
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM0010176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife