Healthcare Provider Details

I. General information

NPI: 1487580262
Provider Name (Legal Business Name): FAITH SUPPLEMENTAL STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 RANCHITO CT APT 18
RANCHO CORDOVA CA
95670-4147
US

IV. Provider business mailing address

2212 RANCHITO CT APT 18
RANCHO CORDOVA CA
95670-4147
US

V. Phone/Fax

Practice location:
  • Phone: 916-583-3587
  • Fax:
Mailing address:
  • Phone: 916-583-3587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMED ZAMBA KONAY SR.
Title or Position: OWNER
Credential:
Phone: 916-583-3587