Healthcare Provider Details

I. General information

NPI: 1003729906
Provider Name (Legal Business Name): IRINA KENT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9847 FALCON MEADOW DR
ELK GROVE CA
95624-2668
US

IV. Provider business mailing address

9847 FALCON MEADOW DR
ELK GROVE CA
95624-2668
US

V. Phone/Fax

Practice location:
  • Phone: 916-299-8100
  • Fax:
Mailing address:
  • Phone: 916-299-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95041476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: