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Individual

MARIAM GBATY SOUMAHORO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3800 SILVER SPUR WAY, SACRAMENTO, CA 95841-4411
(916) 904-0027
Mailing address
3800 SILVER SPUR WAY, SACRAMENTO, CA 95841-4411
(916) 904-0027

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
783011
CA
310400000X
Assisted Living Facility
Primary
342700506
CA

Other

Enumeration date
03/14/2020
Last updated
03/14/2020
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