MEDICARE: MRS. ALYSON KRISTIE POMEROY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1104071612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSON KRISTIE POMEROY

Provider Business Mailing Address
First Line	:	9343 TECH CENTER DR FL 2
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-2563
Country	:	US
Telephone Number	:	916-388-6336
Fax Number	:

Provider Business Practice Location Address
First Line	:	7248 S LAND PARK DR STE 103
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3661
Country	:	US
Telephone Number	:	916-388-6336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	04/10/2023

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