Healthcare Provider Details

I. General information

NPI: 1972813590
Provider Name (Legal Business Name): NATALIA SLABCHAK PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10390 COLOMA RD
RANCHO CORDOVA CA
95670-2152
US

IV. Provider business mailing address

3001 DOUGLAS BLVD STE 325
ROSEVILLE CA
95661-4289
US

V. Phone/Fax

Practice location:
  • Phone: 916-363-2229
  • Fax:
Mailing address:
  • Phone: 916-563-7230
  • Fax: 916-563-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberPA21053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: