Individual
KENISHA ROSE INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3216 PAUMANOK WAY, SACRAMENTO, CA 95835-2450
(916) 470-7404
Mailing address
3216 PAUMANOK WAY, SACRAMENTO, CA 95835-2450
(916) 470-7404
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1022166
CA
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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