Healthcare Provider Details

I. General information

NPI: 1275494957
Provider Name (Legal Business Name): KRISHA PANGILINAN CUASAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

5316 KUNGSTING WAY
ELK GROVE CA
95757-3517
US

V. Phone/Fax

Practice location:
  • Phone: 800-382-8387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95394477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: