Healthcare Provider Details

I. General information

NPI: 1861133050
Provider Name (Legal Business Name): JABALI BEHAVIORAL HEALTH NURSING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 03/08/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 LAGUNA SPRINGS DR STE 200
ELK GROVE CA
95758-7991
US

IV. Provider business mailing address

8627 CAMARGUE CT
SACRAMENTO CA
95828-5947
US

V. Phone/Fax

Practice location:
  • Phone: 530-537-8244
  • Fax:
Mailing address:
  • Phone: 443-414-7767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VERONICA KAMAU
Title or Position: ADMINISTRATION
Credential: PMHNP
Phone: 443-414-7767