MEDICARE: REENTRY DATA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	251S00000X	Community/Behavioral Health Agency
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1770430878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REENTRY DATA

Provider Business Mailing Address
First Line	:	8626 AMESBURY CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-3867
Country	:	US
Telephone Number	:	808-250-9667
Fax Number	:

Provider Business Practice Location Address
First Line	:	8626 AMESBURY CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-3867
Country	:	US
Telephone Number	:	808-250-9667
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KATHY NARASAKI
Credential	:
Telephone Number	:	808-250-9667

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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