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NPI Code Detail

MEDICARE: KATHRYN ANTILL

MEDICARE: KATHRYN ANTILL
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
1183700000XPharmacy Technician11828CA

General Provider Information

NPI Number : 1851843270
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ANTILL
Provider Business Mailing Address
First Line : 3983 VALLEY VISTA DR
Second Line :
City : CAMINO
State : CA
Zip : 95709-9503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 W CAPITOL AVE
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95605-2624
Country : US
Telephone Number : 916-403-2824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2016
Last Update Date : 11/02/2016

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Directions to “ KATHRYN ANTILL ” Practice Location

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