Healthcare Provider Details

I. General information

NPI: 1548085251
Provider Name (Legal Business Name): ENSIGN SAHOTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 INDUSTRIAL AVE STE 207
PETALUMA CA
94952-6529
US

IV. Provider business mailing address

1010 GINKGO PL
WINDSOR CA
95492-8173
US

V. Phone/Fax

Practice location:
  • Phone: 707-292-9018
  • Fax:
Mailing address:
  • Phone: 707-292-9018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: EMILY S SAHOTA
Title or Position: OWNER/MEMBER
Credential: RN
Phone: 707-292-9018