Dutra, Geraldine M

Dutra, Geraldine M is an individual health care provider with primary practice located at 632 W Gibson Rd , Woodland CA 95695-5169. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Dutra, Geraldine M can be contacted via phone (530) 668-2600.

Contact Information

Primary practice address
632 W Gibson Rd Woodland CA 95695-5169
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA14146 California

Profile Details

NPI number 1396917043
LBN Legal business name Dutra, Geraldine M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2008
Last updated Feb 14th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396917043 NPPES
California MEDICAID GR0079250
California Other ZZZ13239Z
California Other PA14146

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