Healthcare Provider Details

I. General information

NPI: 1063422954
Provider Name (Legal Business Name): CARLEENE JANICE CADY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5176 HILL ROAD E.
LAKEPORT CA
95453-6300
US

IV. Provider business mailing address

P.O. BOX 12289
WESTMINSTER CA
92685-2289
US

V. Phone/Fax

Practice location:
  • Phone: 707-262-5000
  • Fax:
Mailing address:
  • Phone: 877-818-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberNP 4345
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 4345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: