Healthcare Provider Details

I. General information

NPI: 1568911287
Provider Name (Legal Business Name): MARISOL NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 MISSION AVE BLDG B
CARMICHAEL CA
95608-2946
US

IV. Provider business mailing address

3637 MISSION AVE BLDG B
CARMICHAEL CA
95608-2946
US

V. Phone/Fax

Practice location:
  • Phone: 916-567-4222
  • Fax: 916-567-4220
Mailing address:
  • Phone: 916-485-4175
  • Fax: 916-485-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: