Healthcare Provider Details

I. General information

NPI: 1437956992
Provider Name (Legal Business Name): SERENITY MOBILE BLOOD SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 GOLD LAKE DR STE 250
FOLSOM CA
95630-2599
US

IV. Provider business mailing address

705 GOLD LAKE DR STE 250
FOLSOM CA
95630-2599
US

V. Phone/Fax

Practice location:
  • Phone: 916-226-1280
  • Fax:
Mailing address:
  • Phone: 916-226-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HAILEY BOLLIS
Title or Position: CO-FOUNDER
Credential: CPT
Phone: 916-226-1280