Provider Demographics
NPI:1679790679
Name:BACIGALUPI, PAUL L II (RN, BSN, PHN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:L
Last Name:BACIGALUPI
Suffix:II
Gender:M
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 FARMER'S CENTRAL ROAD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776
Mailing Address - Country:US
Mailing Address - Phone:530-669-3516
Mailing Address - Fax:
Practice Address - Street 1:137 NORTH COTTONWOOD STREET
Practice Address - Street 2:SUITE 2450
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695
Practice Address - Country:US
Practice Address - Phone:530-666-8645
Practice Address - Fax:530-669-1549
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA575703163W00000X, 163WC0400X, 163WC1500X, 163WP0200X, 251B00000X, 251K00000X, 261QC1500X, 261QP0905X, 281PC2000X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered251B00000XAgenciesCase Management
Not Answered251K00000XAgenciesPublic Health or Welfare
Not Answered261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Not Answered261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Not Answered281PC2000XHospitalsChronic Disease HospitalChildren
Not Answered282NC2000XHospitalsGeneral Acute Care HospitalChildren