Healthcare Provider Details

I. General information

NPI: 1568376077
Provider Name (Legal Business Name): JAMI SCURLOCK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3037 BRYANT PL
DAVIS CA
95618-1613
US

IV. Provider business mailing address

3425 BABSON DR
ELK GROVE CA
95758-6416
US

V. Phone/Fax

Practice location:
  • Phone: 530-400-9752
  • Fax:
Mailing address:
  • Phone: 916-505-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number791061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: