Provider Demographics
NPI:1134895824
Name:SUTCLIFFE, ABIGAIL L
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:L
Last Name:SUTCLIFFE
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 1:2337 BRYCE LN
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-6609
Mailing Address - Country:US
Mailing Address - Phone:530-304-6243
Mailing Address - Fax:
Practice Address - Street 1:2337 BRYCE LN
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-6609
Practice Address - Country:US
Practice Address - Phone:530-304-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer