Individual
DIVYA MATTATHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 21ST ST, SACRAMENTO, CA 95811-5216
(916) 443-3299
Mailing address
1500 21ST ST, SACRAMENTO, CA 95811-5216
(916) 443-3299
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95035843
CA
Other
Enumeration date
01/06/2026
Last updated
01/06/2026
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