Individual
OFA K ENESA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 GIBSON DR STE 100, ROSEVILLE, CA 95678-5792
(916) 774-6802
Mailing address
516 GIBSON DR STE 100, ROSEVILLE, CA 95678-5792
(916) 774-6802
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/04/2026
Last updated
03/19/2026
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