Provider Demographics
NPI:1295805471
Name:TALLARICO, CYNTHIA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:TALLARICO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 ALMANOR CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6601
Mailing Address - Country:US
Mailing Address - Phone:925-455-4072
Mailing Address - Fax:
Practice Address - Street 1:1111-D STANLEY BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550
Practice Address - Country:US
Practice Address - Phone:925-243-1385
Practice Address - Fax:925-243-0127
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN447873163WH0200X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health