Provider Demographics
NPI:1780933085
Name:PARTIDA, ARACELI
Entity type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:PARTIDA
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 1:5324 SHERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-6273
Mailing Address - Country:US
Mailing Address - Phone:209-658-2110
Mailing Address - Fax:209-357-4084
Practice Address - Street 1:5324 SHERWOOD CT
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-6273
Practice Address - Country:US
Practice Address - Phone:209-658-2110
Practice Address - Fax:209-357-4084
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00006299247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other