Provider Demographics
NPI:1902532922
Name:CULLATI, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CULLATI
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 1:5892 OAKHILL DR
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-6004
Mailing Address - Country:US
Mailing Address - Phone:949-689-1424
Mailing Address - Fax:
Practice Address - Street 1:830 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2704
Practice Address - Country:US
Practice Address - Phone:804-828-4635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program