Individual
PA LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
921 SLOBODA AVE, SACRAMENTO, CA 95838-1648
(916) 532-4410
Mailing address
921 SLOBODA AVE, SACRAMENTO, CA 95838-1648
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95021600
CA
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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