Provider Demographics
NPI:1952017055
Name:DECARLI, TRICIA NICOLE
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:NICOLE
Last Name:DECARLI
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 1:329 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-4717
Mailing Address - Country:US
Mailing Address - Phone:707-695-0010
Mailing Address - Fax:
Practice Address - Street 1:329 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-4717
Practice Address - Country:US
Practice Address - Phone:707-695-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula