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NPI Code Detail

MEDICARE: ELIZABETH KENT

MEDICARE: ELIZABETH KENT
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1114863826
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH KENT
Provider Business Mailing Address
First Line : 4980 HILLSDALE CIR STE A
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-5726
Country : US
Telephone Number : 916-607-5913
Fax Number : 916-607-5913
Provider Business Practice Location Address
First Line : 4980 HILLSDALE CIR STE A
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-5726
Country : US
Telephone Number : 916-607-5913
Fax Number : 916-607-5913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2026
Last Update Date : 04/25/2026

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