| Doctor Name: | MS. CARIANNE NICOLE CUNNINGHAM |
| NPI Number: | 1063819829 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 51900 |
| Business Practice Address: | 1255 Las Tablas Rd Suite 201 Templeton, CA - 934659748 |
| Business Phone Number: | 8054342434 |
| Business Fax Number: | 8054345249 |
| Mailing Address: | 1255 Las Tablas Rd, Suite 201 TEMPLETON |
| State: | CA |
| Postal Code: | 934659748 |
| Phone Number: | 8054342434 |
| Fax Number: | 8054345249 |
| NPI Enumeration Date: | 11/21/2014 |
| NPI Last Update Date: | 11/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 51900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |