Ellen Wagner Cutler, D.C

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

12647 Issued in CA

Practice address

116 E Blithedale Ave
Mill Valley, CA 94941-2024

Phone

(415) 302-6989

Fax

(415) 384-0199

NPI assigned

Apr 6, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1760846695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E BLITHEDALE AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412024",
            "telephone_number": "415-302-6989",
            "fax_number": "415-384-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E BLITHEDALE AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412024",
            "telephone_number": "415-302-6989",
            "fax_number": "415-384-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTLER",
        "first_name": "ELLEN",
        "middle_name": "WAGNER",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "12647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Susanna Elizabeth Czuchra, LAC
• Caroline Mary Daate, MA
• Lori A Dali, RD, CNSD
• Grace Dammann, M.D.

• Nutrition Chiropractor in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Nutrition Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.