Provider Demographics
NPI:1124532858
Name:PERRUCCIO, CASANDRA MORRISH
Entity type:Individual
Prefix:
First Name:CASANDRA
Middle Name:MORRISH
Last Name:PERRUCCIO
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 1:604 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4020
Mailing Address - Country:US
Mailing Address - Phone:714-366-7239
Mailing Address - Fax:
Practice Address - Street 1:604 17TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-4020
Practice Address - Country:US
Practice Address - Phone:714-366-7239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula