Healthcare Provider Details

I. General information

NPI: 1669731899
Provider Name (Legal Business Name): FOLSOM DERMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2012
Last Update Date: 05/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 CREEKSIDE DR
FOLSOM CA
95630-3924
US

IV. Provider business mailing address

1745 CREEKSIDE DR
FOLSOM CA
95630-3924
US

V. Phone/Fax

Practice location:
  • Phone: 916-983-2302
  • Fax: 916-983-2382
Mailing address:
  • Phone: 916-983-2302
  • Fax: 916-983-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA A SATTERFIELD
Title or Position: PRESIDENT
Credential: MD
Phone: 916-983-2302